sharlowm
1330015663
Posted 1478193487
Reply with quote #1
Hoping someone has some experience with MD billing for transfers to exempt units, ie psych, rehab. We are getting denials from one ins co. who is saying that when our PMR MD admits to the exempt rehab unit we can't bill the admit codes, we have to use the inpt subsequent codes (31-33) because he provided a consult during the inpt stay, prior to transfer. This goes against the rules for exempt units. All other carriers allow the PMR MD to bill an admit to the exempt unit. It is classified as an exempt unit, the pt is d/c from the hospital and admitted to the rehab unit, the records are not merged. I have been looking all over for something in writing to support this but can't find anything. There is something that addresses this if the MD d/c from hospital and admits to exempt unit same day, but in our case, the PMR MD is not the d/c MD from the hospital. Any help would be appreciated!!!
