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Annie Posted Fri 06th of October, 2017 12:53:56 PM
If a physician discharge a patient from the hospital and within 5 days the patient was readmitted by a hospitalist can the hospitalist charge a initial visit or can he use a subsequent code? I'm asking because medicare doesn't want to pay the discharge because they states that it was excessive discharge.
Annie Posted Mon 09th of October, 2017 09:04:42 AM
If a physician discharge a patient from the hospital and within 5 days the patient was readmitted by a hospitalist can the hospitalist charge a initial visit or can he use a subsequent code? I'm asking because medicare doesn't want to pay the discharge because they states that it was excessive discharge.
SuperCoder Answered Tue 10th of October, 2017 09:19:04 AM

Hospitalist can charge for an inpatient hospitalization when patient gets readmitted to the hospital because of the below mentioned reasons:

  • Premature discharge
  • Inadequate post-discharge support
  • Insufficient follow-up
  • Therapeutic errors
  • Adverse drug events and other medication related issues
  • Failed handoffs
  • Complications following procedures
  • Nosocomial infections, pressure ulcers, and patient falls

Hospitalist would need to bill an appropriate ICD10 CM code concerning the reason of the visit. This would justify the medical necessity of the hospitilization. This will altogether be a new inpatient hospitilization and should be billed with the appropriate CPT and ICD 10 CM codes. 

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