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Coverage & then complications

  1. Question Coverage & then complications
    Medical Coding Books
    The patient had a lap Cholecystectomy w grams by one of my doctors.

    Another doctor in the same office was covering for the first physician. There were atypical complications-hemorrhaging. The second covering doctor also used diagnosis of: cardiomyopathies and unspecified disease of the pancreas.
    The patient was never dismissed from the hospital after the first surgery.

    Can the second doctor bill an initial visit because of the complications or should a subsequesnt visit be billed?

    Thank you for the input.

  2. Default
    If he's from the same office, I don't think he can bill for non-operative treatment of complications during the same hospitalization as the original surgery. My understanding is that a "covering" physician is in the same position as the doc he's covering for, and could only bill medical care for a totally unrelated problem in those circ's.

  3. #3
    St. Louis, Missouri
    I don't believe this is billable either. The hemorrhage would not have happened if the patient did not have the surgery. This would be included in the global of the procedure. If the patient was taken back to the OR for the complication then you could bill that new procedure with a 78 modifier.

    Melissa Blow, CPC

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