MD documents:
My staff & I spent 40 minutes I the discharge process including time speaking with and examining the patient, arranging discharge & reconciling meds & preparing DC paperwork.

We thought total time on discharge had to be provider time only. MD argued that it is staff time but I can't find anything anywhere to support that.

(The total time might include RN time.)

What do you think?


  • All you need to know is what is on page 8 of the CPT book. Do you have one to look at? If not I can copy it and send to you.

    Allison K. Hiott, CCS, CPC, CPC-I
    Remote Professional Coding Specialist
    Reimbursement & Advisory Services Division
    Greenville, SC (Eastern Standard Time Zone)

    Altegra Health | The Promenade at Howard Hughes Center | 6601 Center Drive | Suite 300 | Los Angeles, CA 90045
    C (864) 303-4861 |Allison.hiott@altegrahealth.com


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  • I am looking at Hospital Discharge Services in CPT on pg 18. I only see time spent by physician but MD insists that he saw otherwise from CMS.

  • edited June 2017

    Tell him to produce the evidence! Staff in the hospital is not
    paid/employed by the physician so that is not his liability to bill for.

  • Inpt codes include floor time of the MD.

    Thank you
    Yvette Hofmeister, CPC
    614-685-2915 new #

  • edited June 2017

    Try this site:

    It is from WPS but has all the info from CMS.

  • https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf

    see prolonged care section That might help.

    Thank you
    Yvette Hofmeister, CPC
    614-685-2915 new #

  • edited June 2017

    Usually there is an order written but for billing purposes you only need a
    documented face to face visit.

  • Yes, and you need a discharge summary.

    Maxine Lewis, CMM, CPC, CPC-I, CPMA, CCS-P

    Main: 513-771-7070
    Direct: 513-672-4363

    Fax: 513-326-7640

    200 Northland Blvd

    Cincinnati, OH 45246



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