David Posted Fri 08th of January, 2016 13:12:09 PM
We are finding some of our providers are seeing the patient on their final day in the hospital as an inpatient.....and putting in the progress note....which we end up billing a subsequent inpatient visit. But then a month later is completing a discharge summary.....can we turn around and refund for the subsequent visit we billed and bill for the hospital discharge? Is there a time limit for completion of these or anything saying we can not bill for the discharge if the summary is not completed with in a certain timeframe from the actual discharge date?
SuperCoder Answered Mon 11th of January, 2016 02:43:55 AM
You have to contact your insurance/payer to cancel this final day subsequent visit by explaining the scenario of discharge on same day and provide them discharge summary with procedure codes. Insurance will cancel subsequent visit and rebill correct codes for discharge, calculation will be done and provider will get the amount.
Contractors do not pay both a subsequent hospital visit in addition to hospital discharge day management service on the same day by the same physician. Instruct physicians that they may not bill for both a hospital visit and hospital discharge management for the same date of service.
David Posted Fri 15th of January, 2016 13:19:33 PM
I do know they can not bill for both the subsequent and discharge on the same date. Our issue is that the discharge summary is being done 30 sometimes 60 days down the road......we are not comfortable going back and changing the code because of it being completed so late. Does the length of time matter.....or should we not worry and just correct the charges and bill the discharge regardless of how much time has passed from the actual date of discharge?
SuperCoder Answered Sat 16th of January, 2016 01:26:50 AM
As there is no such guideline for the same, you can correct the charges and bill the discharge.