Wiki Multiple procedure reductions


Burleson, Texas
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My physician is challenging the insurance companies decision to apply to multiple procedure reductions to his surgeries if there is a distinct anatomical site difference. An example would be removal of tonsils under 12, and a unilateral insertion of vent tube. I have tried to explain it to him, its not because its done on a different anatomical site, but because its done in the same surgical session, am I correct? He's thinking he could get higher reimbursement if he does the surgery, wakes the patient, then does another surgery tomorrow which of course raises all other kinds of issues, but that is his thinking. Please help.
Yes, you are correct. Your physician is facing a lot of medical/legal issues if he puts the patient under anesthesia twice just so he can make more money. Check your CMS website for the multiple surgery guidelines and stick to your guns! Good luck!

Thank you so much for the reinforcement, I appreciate it, now I will find a way to explain it to him so we don't get into trouble. Thanks again.