Hi Don,

The ICD-9 code books says: "For surgical procedures, use the ICD-9-CM code
for the diagnosis for which the surgery was performed. If the post-operative
diagnosis is known to be different at the time the claim is filed, use the
ICD-9-CM code for the post-operative diagnosis."

Our hospital codes the patient at the time of registration. All procedures
done in the hospital fall under that code and the patient receives one bill
for all hospital services. The pathology charges are dropped when they are
ordered. There is a 24 hour delay to the bill because they need to go
through an interface. The bill is sent out 4 days after the patient is
discharged. 

I realize from your question that I do not know if that code is changed
before Medicare is billed. I am going to follow up on that next week. 

Sure don't know that much about billing but want to learn more, so thanks
for bringing up the question. 

The goal is maximum reimbursement.

Weather is getting toasty around here. Will probably be over 100 degrees for
the CSH meeting here next week!

Marg
Marjorie Hagerty, H.T. (ASCP) H.T.L., Q IHC
Supervisor, Anatomic Pathology
Eisenhower Medical Center
39000 Bob Hope Drive
Rancho Mirage, California 92270
760.773.2013
FAX:760.773.1587
mhagerty@emc.org