A biller from the other office which Dr. A works for tells me that a physician discharge code has to be used and it has to be a face to face. Since rehab physicians are not required to see patients on the day of discharge, this makes no sense. I suggested that Dr. A just do a progress note as usual and not charge a discharge code but still do the discharge summary. I was told that the physician has to use this discharge code or the patient is not considered discharged. The biller is doing some research since I explained how rehab works but have you ever had this issue come up and if so how did you handle?

Frustrated in the Midwest

There is lots of discussion about this in the world since the CPT discharge codes are not as clear as we would like.  According to this CMS article The discharge codes 99238-39 represent a face to face encounter with the provider while CPT says, “codes include, as appropriate, final exam of the patient, discussion of the hospital stay, even if the time spent is not continuous, instructions for continuing care to all relevant  caregivers, and prep of discharge records, prescriptions and referral forms.”

As far as required billing and payers presuming that a patient is not discharged without a claim to indicate such does not appear logical.  Often, physicians hire another individual to do discharge summaries and they (the physicians) do not report the service.