Well, I don't think this is a stupid question. I have never really thought about it actually.
If the decision for surgery is made that day and they are admitted, then you would bill the admission with a 57 modifier. If the decision for surgery was made prior, as with a scheduled procedure, no you would not bill the admit if it was the same day as the surgery.
This got me to thinking though, a dangerous thing to do, lol.
What if the admit is done greater than 24 hours prior to the surgery? You would be outside the global period, so it shouldn't hit bundling edits. I can envision a scenario where they need the patient to be on IV antibiotics for so many days before they do a procedure. To me that would be a justified reason to bill both the admit and a scheduled procedure.
Hopefully someone else will post additional information on this. Most of the surgeries I deal with are emergencies, not scheduled. I haven't had an orthopod for almost a year now, but this has me wondering if we left money on the table and are continuing to do so.....
Laura, CPC, CEMC
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join