# RE: possible child neglect/postop global



## cynthiaj54 (Apr 7, 2008)

*RE: possible child neglect/postop global*

One of our physicians did a same day surgery on a 2 yr old.  The parents left the hospital before he could talk to them and a family member who stayed with the child said they shouldn't send the child home with the parents as they would not take care of her.  They ended up keeping the child overnight, called in child services and then the relitive changed stories and said it would be alright to send her home.  The physician went in that morning and spent a lot of time with the child and staff getting this all sorted out.  Can he bill anything as this wasn't a typical postop visit?
Thanks


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## ajudd (Apr 7, 2008)

If I was the physician, I would make a follow up appointment for 3 days following the surgery for the parents to bring the young child back in.  That way, he could make sure the post op care is being done.

I almost wonder if CPS could be contacted too.  All anyone has to do is suspect some form of abuse/neglect and they will go investigate.  So, if the follow up appointment was made and the parents cancelled it -(With NO appointment rescheduled) - contact child services and tell them flat out - family member reported a possibilty of non-compliance after a surgery on the toddler and they failed to come in for post op care.

I realize that this could (and probably will) open up a whole can of worms, but I really think that in a case like this the provider should really be on the lookout for that little girl.  I can only imagine why the relative changed her story, maybe she was afraid the child would be placed into foster care - or a host of other reasons.  But the fact is - she was concerned enough to mention it in the first place, so that should be a red flag right there.  Who knows, maybe she recinded because she didn't want to be "stuck" with the toddler herself.  

As far as what the billing could be, can he bill discharge services?  Seeing how she was kept overnight, I wonder if the discharge day codes could be billed since he spent time reviewing the post op care with the patient's parents.


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## rthames052006 (Apr 7, 2008)

cynthiaj54 said:


> One of our physicians did a same day surgery on a 2 yr old.  The parents left the hospital before he could talk to them and a family member who stayed with the child said they shouldn't send the child home with the parents as they would not take care of her.  They ended up keeping the child overnight, called in child services and then the relitive changed stories and said it would be alright to send her home.  The physician went in that morning and spent a lot of time with the child and staff getting this all sorted out.  Can he bill anything as this wasn't a typical postop visit?
> Thanks



I'm wondering if you could possibly bill a prolonged care code 9935_ for this case, take a look at those codes, if you doc has his/her documentation completed with all the details maybe you could -OR- if he d/c'd her that day maybe bill the d/c code 99238-99239.

Just my thoughts,


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