Wiki Inpatient Consults/ICU Care /Postop within global period

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stannler

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I am new to this ENT specialty. Several of our physicians do many surgeries and spend significant time doing follow-up in ICU or other post-op follow-up visits....Typically for complications of surgery (i.e. tonsillectomy bleed or CSF sinus leak), other than billing for the complications procedure, such as 42962 with a -78 modifier. Is anyone aware if there is a way to capture the followup inpatient visits, within the global period, especially critical care/ICU care. I have not been able to find any way to capture any charges aside from a procedure they perform, when in the global period. This is a new specialty for me. Thanks.
 
Capturing reimbursement for complications

Stannler, you have an excellent question but one, we have all ask ourselves and the answer is "no" there is no more codes that you code. When you code the modifier 78 (unplanned return to the operating room by the same physician following the initial procedure during the post-op period) along with the surgery code. I would like to go ahead and add one more thing since you mentioned ICU. These are specific codes that require an organ failure and time to be documented in order to bill for Critical Care, if your provider is providing his daily rounds at the hospital, and his patient is in the ICU, he cannot charge and Critical Care code simply due to the location of the patient. (I'm sure you are already aware of this) unless he is providing life sustaining care for that particular time and has documented it as such. (This can be found in the CPT book in the guidelines under Critical or in any of the online applications available to coders. I hope this has cleared up and questions you may have had.
Theresa Mandl CPC, COC
 
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