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Appy and post op complications

  1. #1
    Default Appy and post op complications
    Medical Coding Books
    Pt had an open appy on 7/27 for ruptured appendix. On 7/31 patient developed a ileus. On 8/6 pt had CVP line put in for venous access. ON 8/8 pt was taken back to the operating room for exploratory laparotomy. At that time he had a small bowel obstruction so lysis of adhesions was done.

    My question is: Patient has BCBS of Texas. Can we bill fot the time he was seen for the ileus before his laparotomy?


  2. #2
    Milwaukee WI
    Default Depends
    Don't know whether BCBS Texas will accept (seems to me most of the Blues follow CMS) ...

    Depending on the documentation, of course, you might be able to code the E/M visit that diagnoses the ileus with -24 and -57 modifiers.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Sounds to me like the ileus was really a small bowel obstruction due to the appendectomy and therefore it is related. So I don't think you can code these visits with a 24. Either way, the ileus would also be related so I don't think you can bill it. Should certainly be included in the global.

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