Q: What do I do about a patient who self-discharges? I have a Medicare patient who hasn’t come back and I can’t discharge their account without G codes.
A: This question has a multi-faceted answer. First, you CAN discharge the account within Systems4PT. To do that, you simply launch a new discharge note from the last signed date of service. This will deactivate the account within the Systems4PT software and remove the account from your work lists.
The G codes, however, will remain open at Medicare. You cannot bill G codes without also billing a CPT code, so unless you can get that patient back in for a final functional outcome test and exam, those G codes will remain open with Medicare and, after 60 days, the CMS will automatically close them and mark the account as “self-discharged.”
The CMS understands that everyone will encounter patients who self-discharge. That said, these self-discharged accounts should be kept to a minimum because if you have more of these than what CMS deems to be “average,” you may invite scrutiny as to why this is occurring. Systems4PT provides you with the tools to recognize Medicare patients who have self discharged so that you can call them to get them back in for proper discharge of their G codes.
The best method for dealing with this issue is prevention. Be sure that your Medicare patients understand that there are open codes associated with their Medicare accounts and that it is important that these codes are properly closed. If you suspect that a patient is about to self-discharge, invite them to discharge properly. You can always open a new account and G code set, but once that patient decides to self-discharge, you may have a tough time getting them back to the clinic. Listen for clues: When someone says to you “Are you sure we need to continue treatment? I feel good!” consider having the conversation about properly discharging their open G codes.