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Observation coding.

  1. Default Observation coding.
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    I work with an ENT doctor. Recently the anesthesiologists that she is working with are requiring that pts with sleep apnea stay overnight in observation after MINOR surgery. She must come back in the morning to discharge. My question: Will Medicare pay for a discharge code after minor surgery if there are no complications? I have looked through many manuals and I'm unable to find anything on this subject. Can anyone out there help? I don't think they will no medical necessity for pt to be there.

  2. #2
    Location
    Milwaukee WI
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    Default 10 day global?
    I'm assuming when you say "minor surgery" that it has a 10-day global period?

    If that is correct, then NO, you cannot code for ANY E/M services related to the surgery during the global period.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. Default
    The codes she is using have Zero global days.

  4. #4
    Location
    Tacoma, WA
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    1,087
    Default
    Quote Originally Posted by dgiretto View Post
    The codes she is using have Zero global days.
    Well technically if there are 0 global days, she could code and bill a discharge. The problem may be in convincing Medicare there was a medically necessary reason for the patient to stay overnight after a "minor" surgery.

    Your doctor could actually write her discharge the same day as the surgery and leave the patient in the care of the anesthesiologist for the overnight observation since that is their order, not hers. Perhaps someone in the hospital administration could help in resolving this issue.
    Last edited by ajs; 12-05-2011 at 06:28 PM. Reason: addition
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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