Medical Coding For Hospital Discharge – Video

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

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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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Laureen Jandroep

CPC, COC, CPPM, CPC-I.,Sr. Instructor for CCO.us. Laureen has over 25 years in the healthcare field. She graduated as an Occupational Therapist in 1986 and before long was running a successful therapy practice which did over 1.6 million in billing per year with a less than .06% rejection rate. Once Medicare changed how rehab companies were reimbursed this business was closed and Laureen eventually started a new company dedicated to teaching Medical Billing and Coding. Laureen has taught medical billing and coding since 1999 and currently does so through her comapny Certification Coaching Organization, LLC which does business as CCO.She resides in Florida with her husband of over 20 years Anthony and four children. They are active parents and spend most of their time these days just being parents which they love.

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