Wiki Surgery billing

[teresa]

PLEASE HELP, IF THE DOCTOR ADMITS A PATIENT TO ACUTE CARE FOR A SCHEDULED JOINT REPLACEMENT THE DAY BEFORE THE PROCEDURE FOR LAB AND I.V.'S. CAN YOU BILL FOR THAT DAY UNDER MEDICARE AND MEDICAID OR SHOULD THE CHARGES NOT BE ADDED TO THE CLAIM.

 

[FTessaBartels]

Scheduled surgery

You state the patient is admitted for scheduled surgery ... in other words, at some point in the past the patient was seen in the office or clinic and a decision was made that surgery was needed, and the surgery was scheduled.

If that is the case, then NO, you cannot bill any E/M for admission to the hospital for the procedure. Yes, I know the hospital will require and H&P. Makes no difference. The reimbursement for the procedure already includes the pre- and post-operative care/evaluation/management.

Hope that helps.

F Tessa Bartels, CPC, CEMC