Inpatient Facility Coding & Compliance Alert

Reader Questions:

Remember This When Reporting a Wrong Procedure

Question:  In an untoward incident, the provider performed the procedure on the wrong side of the body. How do we report this to Medicare?

Delaware Subscriber

Answer:  This event comes under the category of a serious reportable event. CMS may reduce the payment or impart a non-coverage decision on such wrong surgery events. You need to report the E code that identifies “wrong surgery” performed on the patient:

  • E876.5 - Performance of wrong operation (procedure) on correct patient 
  • E876.6 - Performance of wrong operation (procedure) on correct patient 
  • E876.7 - Performance of correct operation (procedure) on wrong side/body part.