anyone using spinal duramorph for post op pain relief after C/S & billing for the post op follow-up? Is this billing kosher or will it get you in trouble with CMS?
Post C/S spinal duramorph billing?
- Thread starter ncdoc1974
- Start date
- Joined
- Jul 13, 2005
- Messages
- 224
- Reaction score
- 3
Some insurance cos will pay for a post op visit; but medicare and medical (CMS) don;t. Check with your billing people.
Trying to sort through CMS guidelines, they seem to think duramorph follow up is not medically necessary & if something is not medically necessary, we can't legally bill for it...(although non billable routine post op notes are obviously needed as they are in all patients) Anyone out there routinely billing for spinal duramorph post op & have a good defense on why it is OK to do so?
This will easily earn you a RAC. You may bill for a spinal, but not the duramorph. Don't be rediculous, you don't want an audit.
- Joined
- Apr 16, 2006
- Messages
- 1,965
- Reaction score
- 2
So they want you to see the patient (post op), but not get paid for it?
How's that different from any 'follow up' for example if a patient went to a Family Prac MD got some drugs tweaked, then came back to 'check in'.
We should all stop doing post ops.
Say you are in a group and you have to 'drive' in to see a patient post op. I think it's fair and reasonable that you get paid for that.
- Joined
- Jun 10, 2007
- Messages
- 558
- Reaction score
- 16
We use duramorph and bill for post op pain management. We follow them and write their pain meds for the 1st 24 hrs. It hasn't been an issue. Standard orders, rarely get called. We don't do that many sections (1 or 2 a day). We have a check box post op pain note that supposedly meets the requirements needed to be able to bill for this. We fill out a separate post op note. It's not much but every little bit helps.
- Joined
- May 3, 2007
- Messages
- 133
- Reaction score
- 9
it is the post op visit that is billed. if it is stated that it is per the surgeon request then it is well reimbursed.
