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nasal bleeding

  1. #1
    Default nasal bleeding
    Medical Coding Books
    Patient went to ER for endoscopic control of nasal bleeding by packing following nasal surgery that was 3 days before. The CPTs for the prior surgery were 30140, 30520, and 31256 so there is a 90 day global period. My question is, can I bill for the endoscopic control of the bleeding with the packing or is that going to be part of the global? Thanks in advance for your help!

  2. #2
    CCI Narrative states:

    "if bleeding occurs in the postoperative period and requires return to the operating room for treatment, a HCPCS/CPT code for the control of the bleeding may be reported with modifier 78 indicating that the procedure was a complication of a prior procedure requiring treatment in the operating room. However, control of postoperative bleeding not requiring return to the operating room is not separately reportable"

    So I guess in your case the question is, was the patient treated in the ER or in the OR? If OR then you can bill it.


  3. #3
    Default nasal bleeding control
    If it was complication due to the previous surgery, then yes you can bill it with a modifier 78 if the patient returned to operating room, with the complication diag code 998.11.

    Hope this helps,
    Kristen Richard, CPC

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