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Intraoperative Death

  1. #1
    Default Intraoperative Death
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    I have an ortho who was performing a bipolar hemiarthroplasty, and at the time he was removing excess cement the patient developed bradycardia. The CRNA initiated fluid resuscitation with medication while the ortho expeditiously reduced the hip, lavaged, and closed the gluteus, subq, and skin. At the family's request via phone, rescuscitative measures were continued for 35 minutes with no responsive results from the patient. My ortho called time of death, and followed medical examiner directions to go ahead and apply sterile dressing to the surgical incision, and leave airway, IV's and the catheter in place.

    Is there anything else I can bill besides 27236/53 for the resuscitation protocol? They made attempts at CPR and also capture with a pacemaker but were unsuccessful. Can I bill 92950 and 92953 for these in addition to the 27236/53? Never had this happen before

  2. Default
    I've had to code this before and as long as there's good documentation (and there usually is during a code), I would do it.
    Bruce Crandall, CPC
    North Carolina Specialty Hospital
    Durham, NC

  3. #3
    Thanks Bruce,

    I can't seem to find an appropriate ICD-9 I just use the bradycardia? Is there a diagnosis code that indicates that the patient expired? I don't have a cause of death documented other than bradycardia.

    Kara Hawes, CPC

  4. #4
    I've never had to code this either, but one code you might look at is 997.1. Probably needs to be coded with bradycardia, but best to review the complication codes under the ICD-9 guidelines.

  5. Default
    Yeah it's a complication for sure! Code your complication and bradycardia like Coderguy said and you've already got the modifier.
    Bruce Crandall, CPC
    North Carolina Specialty Hospital
    Durham, NC

  6. #6
    Thanks guys! I appreciate your help.

    Kara Hawes, CPC

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