Hi! I would like help in clarifying a situation.
8/17 ? MD sees patient. MD enters discharge order at 19:55. MD dictates discharge summary @ 20:18. This includes a statement under Physical Examination that says ?Relatively unchanged today.? and under FollowUp a statement that says ?The patient is going to long-term acute care at . . . ? The LTAC facility is several hours away and sends their own transfer service to pick the patient up.
8/18 ? Transfer service arrives on site @ 00:47. Patient registration/encounter is closed @ 01:22. The MD did not see the patient at all on this date.
When the discharge summary is transcribed, the admit and discharge dates at the top of the summary are auto-populated through the system with the dates the patient?s registration/encounter was opened and closed. Thus, showing the patient?s discharge date of 8/18 because that is when the patient physically left the facility.
Our coding department says the coding world says they cannot bill the discharge on either date without the MD doing an addendum discharge summary to clarify that he saw and discharged the patient on 8/17.
Your time and consideration in reviewing this case would be very much appreciated!
Thank You!
8/17 ? MD sees patient. MD enters discharge order at 19:55. MD dictates discharge summary @ 20:18. This includes a statement under Physical Examination that says ?Relatively unchanged today.? and under FollowUp a statement that says ?The patient is going to long-term acute care at . . . ? The LTAC facility is several hours away and sends their own transfer service to pick the patient up.
8/18 ? Transfer service arrives on site @ 00:47. Patient registration/encounter is closed @ 01:22. The MD did not see the patient at all on this date.
When the discharge summary is transcribed, the admit and discharge dates at the top of the summary are auto-populated through the system with the dates the patient?s registration/encounter was opened and closed. Thus, showing the patient?s discharge date of 8/18 because that is when the patient physically left the facility.
Our coding department says the coding world says they cannot bill the discharge on either date without the MD doing an addendum discharge summary to clarify that he saw and discharged the patient on 8/17.
Your time and consideration in reviewing this case would be very much appreciated!
Thank You!
Question on Discharge
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