Charting and coding for discharge services is not complicated, but many hospitalist physicians find themselves confused when it comes to the CPT codes that are used to bill for hospitalist discharge day services, 99238 and 99239.
The key is to remember that these are time-based codes. They are used to report the total duration of time you spend on the date of discharge. The time does not need to be continuous. This means that the time is actually the sum of the different amounts of time you spend in discharge activities.
Several activities involved in the discharge can contribute to the total time billed:
- Talking to patient and family
- Talking to case management, PT/OT, etc.
- Writing up discharge instructions
- Writing up prescriptions
- Dictating the discharge note
- Speaking with the PCP or other specialist
Once you’ve totaled up the time spent on these activities, you can select the appropriate code: If the time spent was 30 minutes or less, 99238 is the correct code. If time spent was over 30 minutes, the correct code would be 99239.
Regardless of which code you ultimately select, it is important that you remember to document the amount of time spent in discharge day services. This is especially essential if you are using the 99239 code. For example, you might chart: “I spent 40 minutes providing discharge day management.”
The 99238 and 99239 discharge day service codes can be billed by the physician group providing care as the attending service. Consulting physicians bill for services on the discharge date using subsequent visit codes (99231-99233).
