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sandyy2510

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I have a denial for an OPEN hysterectomy done as ambulatory surgery (under 23 hours stay) the rational of this denial is inappropriate place of service, as they are always done inpatient. Can anybody tell me who assigns the POS for surgical procedures?? I looked on the AMA web site and they have no info regarding the various place of services
 
I think the carriers set their own standards on those - I know that Medicare does. I would double-check that case & make certain that the patient actually did stay under 23 hrs. Sometimes we have patients scheduled as out-patient/23 hr & then, because a procedure is converted to open from laparoscopic, or because a more extensive procedure is performed than was originally planned, they wind up being admitted for a longer stay. Even tho this doesn't officially occur until they come out of surgery, it's all considered part of the same stay, & they're considered in-patient for the surgery.
Connie
CPC-GENSG
 
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