Wiki Anesthesia return to OR

[nicci514]

I need some help.....

I have an anesthesia case that was a return to OR for chest exploration after the patient had a CABG. The second case was done later in the evening and it is hitting an edit against the first case. Is there a modifier I should add to the second claim?

Any help would be appreciated.

Thank you,
Nicole

 

[Vannoyj]

I need some help.....

I have an anesthesia case that was a return to OR for chest exploration after the patient had a CABG. The second case was done later in the evening and it is hitting an edit against the first case. Is there a modifier I should add to the second claim?

Any help would be appreciated.

Thank you,
Nicole

Hello,
I have been told by our A/R people that we are to use the modifier 59 for the second case. It sounds crazy, but that is what I was told and I trust the lady who gave me the information regarding a Medicare patient who was returned to OR on same date for a chest re-explore.
Maybe someone else out here has additional information for you.

 

[jkyles]

I need some help.....

I have an anesthesia case that was a return to OR for chest exploration after the patient had a CABG. The second case was done later in the evening and it is hitting an edit against the first case. Is there a modifier I should add to the second claim?

Any help would be appreciated.

Thank you,
Nicole

Based on UHC's policy and the circumstances of your scenario a return to OR modifier would be appropriate.

In the event an anesthesia administration service is provided during a different operative session on the same day as a previous operative session, UnitedHealthcare will reimburse one additional anesthesia administration appended with modifier 59, 76, 77, 78, 79 or XE. As with the initial anesthesia administration, only the single anesthesia code with the highest Base Unit Value should be reported.