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Billing for recovery time

Oscar Posted Tue 16th of October, 2018 18:10:59 PM
Hello, I work for a GI practice and have our own endoscopy center in house; we bill place of service 11. I was wondering if our office could bill for the patient's recovery time and if so what procedure code could we use and what documentation would have to be placed in the medical notes.
SuperCoder Answered Wed 17th of October, 2018 08:37:52 AM

Hi,

In some scenario, the recovery room stay post upper gastrointestinal endoscopy is for about 30 minutes for observation. Therefore, no procedure code should billed for additional recovery time.

Hope this helps.

Thanks.

Oscar Posted Wed 17th of October, 2018 11:37:33 AM
Hi, just to clarify. You are stating that 30 minutes post procedure is included in the global fee; correct? Does this relate only to endoscopies or is any for colonoscopies as well?
SuperCoder Answered Thu 18th of October, 2018 06:46:18 AM

Hi,

Thanks for your question.  Recovery time is a usual and necessary part of the procedure and therefore should not be billed in addition to the procedure code.  Recovery room stays for gastrointestinal procedures typically last until the effects of the anesthesia or sedative has worn off and the patient is safe for discharge. Please see the global surgery package via the link below for more details about what is included in most surgical procedures.

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/GloballSurgery-ICN907166.pdf

Please feel free to ask, if you have any questions.

Thanks.

Oscar Posted Tue 23rd of October, 2018 12:40:14 PM
Thank you very much for your response. Would our office be able to bill for these if we were an accredited ASC (Ambulatory Surgical Center)?
SuperCoder Answered Wed 24th of October, 2018 07:40:39 AM

Hi,

Thanks for your followup query.

As explained earlier, recovery time is a usual and necessary part of the procedure, if performed in an accredited ambulatory surgery center (ASC) it should not be billed in addition to the procedure code.  Recovery room stays for gastrointestinal procedures typically last until the effects of the anesthesia or sedative has worn off and the patient is safe for discharge.

Hope this helps.

Thanks.

 

 

 

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