The spreadsheet in “Evaluating Health Plans: Finding the Keepers” [April 2003, page 47] contains an error. The instructions for calculating days in A/R should read: “Divide the total A/R by the average daily charge. The average daily charge can be determined by dividing annual gross charges by 365.”
In the January 2003 issue, Kent J. Moore’s “Coding & Documentation” article [page 17] incorrectly stated that a hospital discharge and a nursing home admission could not be coded together on the same date unless the physician saw the patient at both locations on the same date. In fact, these services can be coded together on the same date even when the work of the nursing-home admission is done in the hospital during the course of a hospital discharge. In the guidelines preceding the comprehensive nursing facility assessment codes, CPT states that “comprehensive assessments may be performed at one or more sites in the assessment process: the hospital, observation unit, office, nursing facility, domiciliary/non-nursing facility or patient’s home.” Of course, the physician still needs to perform the key components of the nursing facility admission (i.e., comprehensive history, comprehensive exam and medical decision making of moderate to high complexity), even if the service is done in the hospital.