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Laureen: This is a quick one. So, I think this will be our last question regarding hospital discharge.

Q: “Hi Laureen. Quick question. I came across a hospital claim where a patient is being discharged from a normal delivery. What I would like to poke your brain on is, is it correct to use 650 with 99238? There were no complications. For some reason it does not look accurate but I don’t understand, if you could please help???! Thanks in advance.”

Medical Coding For Hospital Discharge – Video

A:  What I did is, I went out to SuperCoder to copy and paste the description, and 650 is normal delivery. It’s basically: “Delivery requiring minimal or no assistance, with or without episiotomy, without fetal manipulation,” etc. But, the use of additional code is what I want to draw your attention to, this is why I like using tools like this, it give us the heads up that we also need to indicate the outcome of delivery. So maybe that was the part that felt a little bit too naked for you that you needed another code. See have your outcome of delivery V code, in addition to the 650. OK?

Then, I had a little note here that, “No you have it correct. All women should pray for a 650!” And then a little side note to also remember that for the 99238, the “Hospital discharge code” only the admitting physician should use that code. All others just use a regular subsequent hospital visit code. Sometimes a specialist might have been brought in, or another physician is also following the patient, so you could only have one discharge code. If you have a couple doctors and, “OK. It was my last time seeing you. I’m going to code a discharge code.” It doesn’t work that way, they have to use subsequent hospital. But chances are if it’s a normal delivery a specialist wasn’t needed.

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