Extended recovery from outpatient surgery


Wilmington, NC
Best answers
Hi, I have a patient that had an outpatient procedure and ended up staying 29 hours in extended recovery, not observation. First, would this still be considered a POS 22 with appropriate codes? Secondly, the provider discharged patient the next day and has charged a level 3 f/u code, what would be the appropriate coding and POS for this? I am getting conflicting information and just wanted to reach out and see if anyone had any guidelines. Thanks! :)
The answer lies in what the patient's official hospital status was. It does not matter where the patient is physically located.
We do a lot of laparoscopic which is considered outpatient. If the patient winds up staying > 23 hours, the hospital makes a decision about whether there was an order to admit the patient, and what that reason was. Abnormal EKG and an order? Then the hospital will admit and notify the insurance.
Was the nurse simply waiting for a signature before the patient could be released? Then it is still outpatient even though 29 hours.
Regarding the following day - was your physician the surgeon? If so, was there a global period? If so, was the visit the following day for services outside the global period? If the visit is indeed billable, again you would need to determine the patient's hospital status to know which group of E&M codes to consider.