Thursday, May 8, 2008

Coding of Unsuccessful procedures

There may be some confusion as to how we handle the coding of "unsuccessful" procedures. These situations occur mainly in the Emergency Room setting.
Coding Guidelines:

If there are unsuccessful procedures, followed by a successful same procedure, only the successful one is picked up. (Example, fracture reductions attempted in the ER and the pt ends up having to go to OR)

If an unsuccessful procedure is performed in its entirety, but the desired result is not obtained, then we still pick that up with no modifier. (Example, LP with no CSF obtained)

Foreign body removal from ear (bug) was unsuccessful. This would be a coded procedure. It was done.

If you come across other examples please forward to me and I can add to the above list.

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