tci Medicare Compliance & Reimbursement - 2014 Issue 8

Reader Question: Encounters vs. Days for Inpatient Visit Coding

Question: A Medicare inpatient was aggressive and needed restraints several times during his stay. In addition, he was put in seclusion after assaulting the staff several times during the night. This required the doctor to get to the hospital within an hour to authorize the seclusion, sedate the patient, calm staff, etc. The doctor saw the patient during regular rounds on Jan. 1, was pulled into the hospital at 3 a.m. Jan. 2 because of the seclusion, and saw the patient for follow-up to seclusion during the daylight hours of Jan. 2. This is three visits within a...

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