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Thread: Valid?

  1. #1
    Join Date
    Apr 2007

    Cool Valid?

    AAPC: Back to School
    I have a chart that is coded as a consult. Reason for the consult is - Postop Medical Management, is this a valid reason for a consult. The patient was admitted to the surgical service due to abdominal pains.

    Pt had a laparotomy due to a ventral hernia that suddenly became strangulated and incarcerated which caused a bowel obstruction. Pt was emergently taken into the OR for the surgery.

    As stated above the reason given for the consult is Postop Medical Managment. Its coded as a second level consult, I see it as a subsequent.

    Any suggestions?

  2. #2
    Join Date
    Apr 2007
    Boston, MA


    From what you describe a consult seems unlikely. Did the surgeon request an opinion from the medical provider? Looks more like the patient was sent to get further tx from medical; surgery did their part in the care of the patient so far. Based on the information you provided I agree with you.
    Karolina, CPC, CPMA, CEMC

  3. #3
    Join Date
    Apr 2007
    Capital Coders, Columbia, SC


    Hmmmm. This confuses me a little. The physician who performs the surgery assumes the followup care of the patient, no? If the surgeon is sending the patient to someone else for followup care, should he have billed the surgery with modifier 54? And the followup physician bills his services with modifier 55?

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