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This presentation reviews how hospital-to-hospital transfers affect billing and coding, common coding errors, and how to avoid them.
To transfer or not to transfer – that is the question. The medical decision to transfer a patient to another acute-care facility is not an easy one. While medical necessity is always at the heart of this decision, the impact to hospital and physician reimbursement are also contributing factors.
The safety and wellbeing of the patient should always dictate the level of care. If a patient is stable and warrants or needs a transfer to another acute-care facility, the billing must accurately reflect the transfer. Although Medicare has edits in place to determine if a hospital miscoded a hospital-to-hospital transfer on their claim, it is the responsibility of the provider to submit accurate claims. Additionally, reflecting the highest level of care in the discharge status code is not necessarily correct.