tci General Surgery Coding Alert - 2006 Issue 11

Don't Allow Missed Appendectomy Opportunities to Burst Your Reimbursement

A distinct Dx goes a long way in proving the separate -- and separately payable --nature of appendectomy Commercial and Medicare payers frequently bundle appendectomy to other abdominal procedures the surgeon performs during the same operative session. But that doesn't mean you should -write off- every appendectomy as unreimbursable. You can separately report --and be paid for --appendectomy if the procedure meets two requirements:1. There is a documented problem with the appendix2. Other procedures during the same session do not relate directly to the right colon. Don't Expect Reimbursement for -Healthy- Removal Here's an iron-clad rule: Medicare (and others)...

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