Wiki Chest tube placed 2 days postop CABGx3

[gski]

OP report states: The patient is status post CABG x3 (2 days) with the early incidental removal of a prior left Blake chest tube that had been initially inserted intraoperatively with a subsequent left pleural effusion and hypoxia.

Is the chest tube insertion (32551) billable in this circumstance, or would it be considered bundled in the global days for the CABG? Modifier 78 cannot be used since the procedure was performed at bedside in CVU, not in the OR/Procedure room.

Thank you for your opinions!

 

[dvance4210]

I believe your right in thinking that this would not be a billable service...it is in the global period and it was performed at bedside as well.

Dorinda

 

[OCD_coder]

Ok, what about this thought.

My thoughts are the chest tube is being place into the lung and this isn't related to the CABG as they are different organ systems. Since the 32551 has no global period, the more appropriate modifier is the 79 as there is no need to go to the OR or procedure room by description.

I would defend it with this information/thought process. But would love to hear thoughts from anyone.

 

[emoates]

STS states that the post-op insertion/removal of chest tubes is included in the surgical package.

 

[gski]

Thanks so much for your replies & feedback!!

 

[SEARNEST]

It would be difficult to argue that the pleural effusion was not a result of the CABG, as it is a common post-op problem.