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HASA

Transition of care codes to benefit

physician income

By Gijs van Oort, PhD

While many clouds surround the current changes in health- reviewed by a designated office person for follow-up appropri-
care, a few silver linings are starting to appear, both for the ateness. This notice lets the physician’s staff know that one of
practitioner as well as the patient. One of those relates to their patients has been discharged and provides a high-level
timely notification and follow-up of a patient discharged from overview of the hospitalization encounter. If a physician wants
an inpatient hospitalization. CMS has assigned specific CPT to know about the patient (including events and test results
codes 99495 and 99496. While not covering all discharges, that are currently not in the patient’s record) this can be ac-
given the increasing complexity of hospitalizations, many pa- cessed through the provider portal, another service provided
tients will benefit from timely follow-up by their physician fol- by the HIE.
lowing such an event.
Even if the thinking behind the process makes sense, it can BILLING CODE SPECIFICS
quickly result in additional work in the office with question- What are the specifics about this billing code? Only one
able pay-off in the end. Health Information Exchanges like provider can bill for a patient discharge. CMS rules state that
HASA, however, will be adding an alert capability to do just the first eligible claim is paid. The HIE will typically send the
that; send an electronic notification to the physician office’s notification to the primary care provider if available from the
“inbox” (a secure and encrypted email look-alike) that can be admission encounter. Over time, HASA can send the notifi-

32 San Antonio Medicine • February 2014