Otolaryngology Coding Alert

Question: Our patient had a tonsillectomy. Four days later, she came to the ER with a postoperative bleed that required a trip to the operating room to control; she was then admitted overnight. Three days later, the patient arrived in the ER and was seen for another bleed, which was subsequently controlled in the operating room. The doctor again admitted the patient overnight. I should report 42962-78 for both dates. May we code for the ER visits? How about the admission and discharge also? Utah Subscriber Answer: The answer depends on whether the patient is a Medicare patient or has insurance that states in writing that they follow Medicare rules for postoperative complication care. Medicare states it does not pay for postoperative complications unless they require a return to the operating room. Therefore, any care for complications done in the office, bedside, or in the emergency room during the global [...]