readmisson

TRISLEY

Does anyone have readmission guidance when readmission is discovered and combining of accts for Medicare patients?

RHirsch

If you read the regulations, CMS only allows combining the admissions when the patient is readmitted on the same day for the same reason. All other admissions are billed separately and result in  separate dRG payment. There is no provision that allows combining admissions unless it was a planned readmission with a leave of absence. 

rather than type it all, read this: https://www.racmonitor.com/hospital-admissions-combining-two-into-one-doesn-t-add-up
and this: https://www.racmonitor.com/hospital-admissions-part-ii-the-finances-of-combining-admissions-and-the-readmission-penalty