this questioning this specifically to ask how to handle a patient who converts from an inpatient hospital stay to an inpatient hospice stay. The patient remains in the same hospital and even in the same room but their designation is changed over from inpatient to hospice
Patient is Admitted on Day 1 and stays in hospital for 5 days.
Doctor Bills as Following
Day1: 99223 - Level 3 Intial
Day 2 to 4: 99232 - Level 2 Subsq
Day 5: Discharge to inpatient hospice 99239 ?is discharge appropriate here
Day 6: with this day be a initial visit (99223) with GV modifier - or should this be billed as a subsequent 99232 with GV modifer
Patient expires on Day 8:
Hospital requires a new history and physical to be dictated and completed in the chart when the patient is converted from an inpatient stay to a hospice inpatient stay.
CPT states you can only report a discharge as long as the patient was not admitted the same day, if the patient was actually discharged on Day 5, left the hospital and was re-admitted the next day you could charge for the discharge as well as the Admit code, as long as they were on different days. I would say you can charge face-to-face visits but not another initial visit if it was only transfer of care. Hospice’s admission date will actually be the start date of the benefit period when the patient entered hospice. I would suggest reading Medicare Claims Processing Manual Chapter 11 - Processing Hospice Claims for more information.