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Decision for surgery

  1. #1
    Default Decision for surgery
    Medical Coding Books
    I have a patient who has colon cancer and I have scheduled for surgery. He also has thrombocytopenia due to myelodysplasia. He will need to be admitted the day before surgery for platelet transfusions. Once his platelet count is above 100,000, I plan on operating on him.

    Has the decision for surgery already been made or can I code for the admission the day before with a 57 modifier with the decision for surgery being made after his platelet count is acceptable to proceed with surgery?

  2. #2
    If I were auditing this I would consider the decision already made and the inpatient visit would be included in the global period of the surgery.

    Laura, CPC, CPMA, CEMC

  3. #3
    Daytona Beach, FL
    I agree with Laura - the decision was already made to perform the surgery and the patient is being admitted one day earlier for the transfusion for the surgery. Any visit performed on the day of admit is part of the global.

    Jodi Dibble, CPC

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