I am aware of the NCCI policy regarding repair of an iatrogenic laceration or perforation caused during a procedure not being billable when both are done by the same surgeon. However, I have a slightly different scenario and I would appreciate some input.

Surgeon A, who goes to a rural location once a week to hold clinic and perform procedures, does a colonoscopy at a rural hospital. The patient tolerates the procedure well and is sent home after recovery. She develops abdominal pain that worsens throughout the day. She returns to the ER at the rural facility and a CT reveals the presence of diffuse intra-abdominal air involving the pelvis, retroperitoneum, and mediastinum. She is transferred to our facility for a higher level of care. At this point it does not say that the colon has been perforated and there is no mention of it in the original surgeon’s Op Report.

Surgeon B takes the pt into surgery, finds the perforation as well as fecal contamination and peritonitis. He performs a colectomy with end colostomy.

Both physicians are members of the same surgical practice. Is Surgeon B’s charge billable?

Thanks for any input you can offer,

Cate