Post-Tonsillectomy Hemorrhage 42961

[SUEV]

Code 42961 is for the control of hemorrhaging "requiring hospitalization". My doc admitted the pt to observation status, cauterized the tonsillar fossae and the patient left over 12 hrs after admission on the same day. Does anyone know if the "hospitalization" only pertains to inpatient or would this scenario qualify?
Thanks,
Sue

 

[jthweatt]

I think that cauterization would be simple control (42960) regardless of hospital status.

Jerri

 

[FTessaBartels]

42960 vs 42961 vs 42962

Here's the lay description from Encoder Pro
The physician controls bleeding of the oropharynx. Primary hemorrhaging occurs within 24 hours after surgery; secondary hemorrhaging occurs 24 hours to two weeks after tonsillectomy. In 42960 and 42961, hemorrhaging is controlled using methods such as clot evacuation and applying pressure with sponges, electrocautery, or application of vasoconstrictor solutions such as tannic acid, silver nitrate, and epinephrine. Cellulose sponges that expand when placed in the tonsillar cavity may be used. Report 42961 when extensive bleeding requires hospitalization. In 42962, surgery is required to control hemorrhaging. Surgical intervention methods include suture ligation of bleeding vessels. In cases of profuse bleeding, emergency ligation of the external carotid artery may be performed. The tonsillar pillars may be approximated with sutures to control post-tonsillectomy bleeding.

Hope that helps

F Tessa Bartels, CPC, CEMC

 

[SUEV]

Hospitalization

Thanks for the descriptions. So, would you say admission to observation status for this issue can be considered a "hospitalization"? I want to say yes but I'm not sure

 

[jthweatt]

Thanks from me too!

Jerri