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Post op management TPN

Bonnie Posted Tue 26th of June, 2012 01:30:16 AM

Patient in hospital for pancreatic neck resection. Post operatively the surgeon initiates order for TPN. Would the TPN management by the surgeon be considered unrelated to the condition for which the surgery was performed and therefore qualify to append modifier 24 to the subsequent visit code? Thanks

SuperCoder Answered Tue 26th of June, 2012 06:11:11 AM

For placement of a catheter for use during total parenteral nutrition, or TPN, you can code a CVP insertion code (36555-36571). But for regular TPN management or initial ordering, you can use E/M code for appropriate InPt. condition (99231-99233). Append modifier 24 with the E/M code to specify that you are performing a separately identifiable service within the global period.

Bonnie Posted Tue 26th of June, 2012 12:32:30 PM

Thank you- I was on the fence in determining if TPN management would be included under global service since it appears that patients with extensive GI procedures typically receive this service.

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