Reader Question: Control of Bleeding Requires Return to OR
Question: Several days following a planned tonsillectomy in the ASC, the surgeon brought the patient back to our facility for control of bleeding. How should I report this?
Indiana Subscriber
Answer: When the surgeon controls post-tonsillar or postadenoidal bleeding during the surgery’s global period, you may be able to charge separately for the service if the procedure requires a return to the operating room.
In an ASC setting, you can choose from among two codes to describe procedures to control post-tonsillar or postadenoidal bleeding:
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42962 -- Control oropharyngeal hemorrhage, primary or secondary (e.g., post-tonsillectomy); with secondary surgical intervention
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42972 -- Control of nasopharyngeal hemorrhage, primary or secondary (e.g., postadenoidectomy); with secondary surgical intervention.
Because Medicare bundles all care of postoperative complications that do not require a return to the operating room into the original procedure, you should not report 42960 (Control oropharyngeal hemorrhage, primary or secondary [e.g., post-tonsillectomy]; simple) or 42970 (Control of nasopharyngeal hemorrhage, primary or secondary [e.g., postadenoidectomy]; simple, with posterior nasal packs, with or without anterior packs and/or cautery) for Medicare payers.
These are simple procedures, usually performed in the surgeon’s office (and therefore not generally billed in an ASC in the first place).
- Published on 2007-08-24
SuperCoder
