Wiki Primary dx for appendicitis after appendix is removed?

[heatherfrycpc]

Hello all,
I'd love your input. I'm coding pediatric physician inpt visits. When a patient comes in for an appendectomy, after the appendix is removed but the patient is still inpt for postop, what do you use as the primary dx?

I had been taught to use appendicitis (540.0) for the duration of the stay- even though there is no appendix to speak of- it's the reason for admission and why the patient is there. My docs aren't doing the surgery- so it wouldn't be the V code for postop visit.

My auditor is saying we can't use that but need a different code. I'm trying to find some sort of guideline on it. Does anyone else do it this way? Am I wrong?

Please help!

 

[mitchellde]

You use the appropriate V code for post op after care or follow up which ever is appropriate. You never usae a dx code for a condition the patient does not currently have.

 

[cynthiabrown]

why are you billing post op care?

 

[mitchellde]

A non surgeon can provide post op follow visits, you just use the follow up V codes.

 

[ChristieH]

Why is your doc seeing the pt? I work for infectious disease docs who are always being consulted by other physicians and hospitalists to see a pt who is in the hospital. Obviously, they are consulted mostly because of an infectious process possibly being in the mix of their illness/admission. If pt is having symptoms of an infection after sx such as an appendectomy, it is usually a peritonitis code as #1 and then fever and leukocytosis or whatever the symptoms are.

So, I am coding the reason my doc is seeing the pt in the hospital as my first listed code. Are you billing for the hospital or the physician/hospitalist? Did the surgeon ask your doc to provide the follow up care?