Wiki Return to OR after D&C complication

[Sdrivera]

Patient underwent a D&C (59812) and then returned to the OR ~1hr later due to copious amounts of vaginal bleeding. Is 59160-78 allowed in this scenario? Or is this complication included with the 59812 90-day global?

 

[csperoni]

The Medicare Global Surgery booklet is currently under revision and not currently available. However, when it was available, this was listed under "What services are not included in the global surgery payment?"
- Treatment for post-operative complications requiring a return trip to the Operating Room (OR). An OR, for this purpose, is defines as a place of service specifically equipped and staffed for the sole purpose of performing procedures. The term includes a cardiac catheterization suite, a laser suite, and an endoscopy suite. It does not include a patient's room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient's condition was so critical there would be insufficient time for transportation to an OR).
This would be an appropriate use of -78. Here is Novitas' fact sheet for -78.
I would however check your CPT codes. 59160 is for curettage, postpartum.

 

[Sdrivera]

The Medicare Global Surgery booklet is currently under revision and not currently available. However, when it was available, this was listed under "What services are not included in the global surgery payment?"
- Treatment for post-operative complications requiring a return trip to the Operating Room (OR). An OR, for this purpose, is defines as a place of service specifically equipped and staffed for the sole purpose of performing procedures. The term includes a cardiac catheterization suite, a laser suite, and an endoscopy suite. It does not include a patient's room, a minor treatment room, a recovery room, or an intensive care unit (unless the patient's condition was so critical there would be insufficient time for transportation to an OR).
This would be an appropriate use of -78. Here is Novitas' fact sheet for -78.
I would however check your CPT codes. 59160 is for curettage, postpartum.

Thank you!