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Can You Bill Medicare – When the Patient Has Died

Can You Bill Medicare – When the Patient Has Died

A confusing medical billing situation can arise when a patient dies en route or shortly after being admitted to a hospital. Many medical billers struggle with what to report or amount of procedures to report that were performed prior to the patient expiring.

A good example would be a patient that presented in the ED for CPR direction. The ED physician tells EMS to perform defibrillation and administer medications. When EMS brings the patient into the ED, the doctor examines the patient and decides there isn’t cause to continue CPR and pronounces the patient dead. How should this be reported?

Normally, on your medical billing form, you would usually bill 92950 (Cardiopulmonary resuscitation) and 99288 (Physician direction of emergency medical systems [EMS] emergency care, advanced life support) to your local Medicare carrier, and many times Medicare will reject this claim as with the notation “not necessary”.

The reason for this is, Medicare protocol usually directs that the doctor should be face to face with the patient to bill for any services rendered. The fact that the physician was directing others, no matter how qualified to perform the services, means in Medicare’s eyes, the physician didn’t actually render any services to the patient in that regard. The closest coding a physician can bill for in this situation would probably be running a code in the emergency department, even if the doctor isn’t actually performing the compressions on the patient, the fact the doctor is present and at bedside as procedures are performed make it a viable coding for your medical billing form.

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