Fx'd rib during thoracic surgery

[LisaLMay]

Inadvertently, the surgeon fractured one of the patient's ribs when doing a decortication and wedge resection. He performed an open reduction with internal fixation on the rib...is this billable?
Thank you,
Lisa May, CPC

 

[FTessaBartels]

Not my specialty

Not my specialty but ... I'd say no.

F Tessa Bartels, CPC, CEMC

 

[lking]

fx rd ribs

I also would say no if you did it you fix it

 

[MLS2]

I'm in aggreance with the above...I wouldn't bill it

 

[mitchellde]

I disagree, I have always coded the intraoperative complications and the fix, sometimes they are paid and sometimes not. However I feel it is good tracking to code the complication with the E code and the procedure performed to correct the complication. I do not know of any "rule " per sey on this. However it was an additional procedure performed due to an iatrogenic complication.

 

[RebeccaWoodward*]

Although CMS does address provider errors, I'm not sure this falls under that category. If your provider/administration could demostrate a reasonable explanation for billing for this service, I would let them make that decision. There is always your local medical society for their input. I'm sure there are other variables we aren't aware of for this particular scenario.

http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=3408&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1,+2,+3,+4,+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

 

[mitchellde]

I agree they do under the category of never events, I do not think this qualifies as a never event which is why I would code it, I equate this to the same as a spinal surgeon having to do a dural repair due to a fluid leak, or nicking an artery necesitating an arterial repair. While these things do not always happen, they do happen and thank goodness they can be fixed, it was probably unavoidable but something that happened in order to accomplish the primary objective. This is why I would code it and submit it as a complication.