Cancelled Procedure

k.bloodsworth@smmctx.orgk.bloodsworth@smmctx.org
edited March 2016 in Clinical & Coding
Curious as to what other facilities do...

I had a patient scheduled for an elective TKA. In pre-op, the patient was found to be in bigeminy with HR in the 30s per EKG. The physician cancelled the procedure and referred the patient for a cardiology evaluation as an outpatient.

Do you leave the patient as an inpatient and if so what coding sequence would you use and with what if any modifiers?

Do you change the patient status to outpatient?

Comments

  • tcrosslintcrosslin
    edited March 2016
    Medicare has guidelines concerning this. If the patient's surgery gets cancelled before the induction of anesthesia the claim will not be paid if billed as inpatient.

    For private insurance and HMOs that have prior auth for inpatient, we bill the testing that done as outpatient and the office will have to get a new auth (or get the date changed for the one they have) before the surgery can be rescheduled.

    Theresa Crosslin RN CM
    Cookeville Regional Medical Center
    931-783-2078
    TCrosslin@crmchealth.org

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