medicalsec
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Re: Table of Risk and Appendicitis
Our hospital has a special program where they bill for the surgeon for those who did not have insurance and the surgeon is reimbursed under this special program.
They do not necessarily consider a pt who presents to the ER with an appendicitis to be under the emergency major surgery category on the Table of Risk. They are also looking for one or more chronic illnesses with severe exacerbattion. In my mind, I had always thought that an appendicitis would be a condition that would be considered an emergency surgery because it would be life threatening if it was not treated upon presentation. The hospital tends to bill a 99222 rather than a 99223 and these are in the cases where the doctor has met all of the other comprehensive categories. If this is the case, then I would assume that only people that were bleeding severely would be considered an emergency major surgery or someone that was septic, or had severe vascular insufficiency. I don't understand the rationale.
How do other codes an appendicitis?
Thanks,
Dee
Our hospital has a special program where they bill for the surgeon for those who did not have insurance and the surgeon is reimbursed under this special program.
They do not necessarily consider a pt who presents to the ER with an appendicitis to be under the emergency major surgery category on the Table of Risk. They are also looking for one or more chronic illnesses with severe exacerbattion. In my mind, I had always thought that an appendicitis would be a condition that would be considered an emergency surgery because it would be life threatening if it was not treated upon presentation. The hospital tends to bill a 99222 rather than a 99223 and these are in the cases where the doctor has met all of the other comprehensive categories. If this is the case, then I would assume that only people that were bleeding severely would be considered an emergency major surgery or someone that was septic, or had severe vascular insufficiency. I don't understand the rationale.
How do other codes an appendicitis?
Thanks,
Dee