How To Code For Swing Bed Services

Coding for visits to patients in Swing Beds

March 12th, 2009 - Codapedia Editor

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Physicians should bill for patients in facilities based on the condition of the patient in the facility. This is truthful for Observation, Inpatient and nursing facility status. The status billed by the facility and the Eastward/Yard codes selected and reported by the physician should friction match.

Some hospitals have beds that they designate as swing beds: the patient can accept either inpatient or nursing facility condition. Here is what the Medicare Claims Processing Transmission says near this: (Pub 100-04, Chapter 12, Section 30.half-dozen.ix D)

D. Visits to Patients in Swing Beds
If the inpatient intendance is being billed by the hospital equally inpatient infirmary intendance, the infirmary
care codes employ. If the inpatient intendance is being billed by the hospital every bit nursing facility
care, then the nursing facility codes use.

That is, if the patient is assigned inpatient hospital condition, bill with codes 99221--99239. For subsequent hospital visits, use codes 99231-99233.

If the patient is assigned nursing facility status, bill with nursing facility E/One thousand codes, 99305--99310. Information technology is not payable to bill a discharge from the hospital and access to a nursing home for the start 24-hour interval the patient's status changes in a swing bed. Bill only a subsequent visit. This is described later in that section of the manual:

E. Doc Services Involving Transfer From One Hospital to Another; Transfer
Within Facility to Prospective Payment System (PPS) Exempt Unit of Infirmary;
Transfer From One Facility to Another Separate Entity Under Same Ownership
and/or Part of Same Complex; or Transfer From One Department to Another
Inside Single Facility

Physicians may bill both the hospital discharge direction lawmaking and an initial infirmary
care code when the discharge and admission practice non occur on the same 24-hour interval if the transfer
is between:

Dissimilar hospitals;
Different facilities under common ownership which do non have merged records;
or
Betwixt the acute care hospital and a PPS exempt unit of measurement within the same hospital
when in that location are no merged records.

In all other transfer circumstances, the physician should beak simply the appropriate level of
subsequent hospital treat the date of transfer.

I have bolded the last sentence of this section, in support of billing just a subsequent service on the engagement the patient is transferred from inpatient to nursing facility condition (swing bed).

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