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Wiki cpt code 42961
- Thread starter jocoffey
- Start date
Candice_Fenildo
Guest
Because the hemorrhaging was extensive enough to require treatment in the Hospital you should report complex post-tonsillectomy bleeding code 42961.
Contributing factors such as dehydration or need for fluid replacement in any patient who has bleeding may warrant observation or hospitalization even after bleeding subside.
On the other hand though. You have to consider the Payer. Medicare does not pay for complications treated outside of the operating room you do not bill 42962 or 42961. (Medicare considers it part of the global.) Many private payers consider postoperative bleeding unrelated to the tonsillectomy and reimburse for 42960 and 42961. You would use -79 On the 42961
Contributing factors such as dehydration or need for fluid replacement in any patient who has bleeding may warrant observation or hospitalization even after bleeding subside.
On the other hand though. You have to consider the Payer. Medicare does not pay for complications treated outside of the operating room you do not bill 42962 or 42961. (Medicare considers it part of the global.) Many private payers consider postoperative bleeding unrelated to the tonsillectomy and reimburse for 42960 and 42961. You would use -79 On the 42961