Wiki Advice Needed

[Jody Mortensen]

Hi, I don't believe that I have the proper terminology but need advice in understanding Medicare's policy on surgeries classified as inpatient procedures but done as an ambulatory service. I coded a ambulatory surgery for an open removal of the gallbladder with CPT code 47600 on a Medicare account & receiving an edit in our claims processing software stating this is an inpatient surgery. The procedure started out laparoscopically but was converted to an open procedure due to extensive adhesions. The patient went home the same day. The biller is asking me if there is anything else I can do & I am not aware of anything else. Does anyone have advice, knowledge for me concerning this?

Thank you
Jody Hecht

 

[LLovett]

As far as I know, neither lap or open are covered procedures for a medicare covered individual in the ASC setting.

Unless there was an ABN signed before the patient had the procedure there is nothing you can do but bill it and take the write off.

Laura, CPC