Wiki Incidental Appendectomy ICD-9

[southernbutterfli]

One of the physicians in my office performed a patient requested appendectomy while she was also having a bilateral tubal oophorectomy performed to remove several ovarian cysts, which was performed by another physician (not within my practice). The patient was not having any symptoms to warrent the removal of her appendix, but wanted to have it removed to avoid any future surgeries. I am now stuck with what may turn out to be a free surgery performed by the physician, because he failed to inform me of the upcoming surgery so I could try to get approval, and he also failed to inform the patient that she may be financially responsible if her insurance would not cover it.

I did some research and found ovarian cysts can be vaguely related to appendicitis. Does anyone know if BCBS (or any other plan) will accept ovarian cysts as a diagnosis for the voluntary removal of an appendix during another procedure? I would really like to be able to get some type of reimbursement for his time and services.

Thanks for any help
Melissa

 

[mitchellde]

Do not try to make this more than what it was. You absolutely can not use a dx that was not the reason for a procedure and there is a world of different in an ovarian cyst and an appendix!! He did not remove the appendix due to the ovarian cyst. You must code this as a V code either for elective removal ( I think it is V50) or there may be one for incidental appy. If a waiver was not obtained, the patient was not informed, then this is on the doc.

 

[southernbutterfli]

Thanks for the help!!