Author Topic: I had a question on the 99236 admit/discharge same day  (Read 1598 times)

Michele

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I had a question on the 99236 admit/discharge same day
« on: March 21, 2008, 06:03:19 AM »
Question
Michelle,

I had a question on the 99236 admit/discharge same day.  I have been having trouble with this code.   Usually I use pos 21 for inpatient but I am finding that some insurance companies deny the claim stating outpatient.  Should this be billed as outpatient or inpatient?

Also, I wanted to know if you knew what diagnosis code I could use for intractable headaches. 

Thanks
Miriam

Answer
Hi,

   I always understood that the place of service was 21 if it went over (the number of hours that makes it an inpatient stay, which I can’t seem to come up with right now!) and if it was under that number of hours, then you would use 22 for outpatient.  Also, if you were billing it with the outpatient place of service, then it wouldn’t make much sense to be billing an admit and discharge.  I think I would argue this one out with the insurance carrier.

Regarding the headaches, it looks like you add a fifth digit of 1 to the appropriate migraine diagnosis to indicate intractable.  See the following chart:

              346 Migraine

                     The following fifth-digit subclassification is for use with category 346:

                      0 without mention of intractable migraine

                      1 with intractable migraine, so stated

              346.0 Classical migraine

                         Migraine preceded or accompanied by transient focal neurological phenomena

                        Migraine with aura

              346.1 Common migraine

Atypical migraine

Sick headache

  346.2 Variants of migraine

Cluster headache

Histamine cephalgia

Horton's neuralgia

Migraine:

abdominal

basilar

lower half

retinal

Neuralgia:

ciliary

migrainous



   346.8 Other forms of migraine

Migraine:

Hemiplegic       

ophthalmoplegic



     346.9 Migraine, unspecified

Hope that helps,
Michele
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