01/31/2022

Billing Medicare for a Patient Passing the Same Date They Were Seen

if a patient is seen in a nursing home and expires the same day, will medicare deny the visit or is there a specific code to indicated that the patient was seen prior to death?

If a patient passes away on the same day that they were seen, Medicare should pay for the visit. There is no modifier or data qualifier that can be appended to a claim for a patient was seen before they passed away. When claims are submitted, a visit will only be denied related to the patient’s death date if the service date is after the recorded date of death with the Social Security Administration.

Services on or before the date of death should process normally. In the instance that a claim is denied due to a potential issue with the date of death (the incorrect date may be recorded to the Social Security Administration), supporting documentation from the attending physician of the facility that clearly documents the date of death (with the exact time) compared to progress notes of the podiatry visit prior to the patient passing should be submitted as a redetermination in the unlikely event that the claim is denied.