# Control of post op bleeder



## codedog (Oct 18, 2010)

Patient had an adenoidectomy  at our ASC early in moring. Patient came back  same day later in afternoon for a postoperative adenoidectomy bleeding. 
  CPT code to choose from are 42970 -42972
         which one is best for asc 

 opeartive report read as follow-   after atisfactory anesthesia was established, the Jrnnings mouth gag was inserted. The clots were removed from the nasopharynx, the nose and nasopharynx were irrigated, and difuse low grade bleding from the adenoid bed was identified and controlled with cautery. The area was carefully obserrved fora period of about 10 min, and no futher bleeding occured. Silver nitrate was applied to the anenoid bed. 

CPT CODE 42970- SOUNDS SIMPLE , BUT IT DOES SAY CAUTERY
CPT CODE 42971- SAYS REQUIRING HOSPIALIZATION -WE ARE ASC 
CPT CODE  42972 -SAYS SURGICAL INTERVENTION- ? NOT SURE WHAT THEY MEANT 

i AM GUESSING 42970 WITH A MODIFER 78   ?????????


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## preserene (Oct 18, 2010)

I feel the code 42970 with the modifier perfectly describes the scenerio.  
Complicated when we  find it is not amenable with this simple procedure of controlof the bleeder, or the patient came with severe bleeding in as to hypovolaemic shock etc.

 Secondary surgical intervention means the patient needed another major or minor surgical procedure say, involving anesthesia and/ opening up the previous wound or site , explore, catch the bleeding vessel with instruments and make reinforcing suture or even some major surgical procedure involving extension of the wound and deep exploration of surrounding anatomical tissues and sites/ an dthier damage,suture major vessels  stuff like that.
Hope you get my point.
Thank you  for tuning in.


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## codedog (Oct 18, 2010)

thank you preserene , theway youexplain it makes more sense-thanks


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