SPU vs INPT and CPT

If a patient has surgery at 9am and is kept overnight, can that still be considered SPU? Also, the doctors are billing a consult (99244) and an outpatient office visit (99213) on the second day post op in the hospital setting. Is that correct?

What is SPU?

Don't know that abbreviation...and what insurance?
is your doc the surgeon?
What do you mean second post-op day?
what was procedure?

information needed

If the surgery has a global of 90 days, the post-op visit cannot be billed. If the consult was by the surgeon day before or day of major surgery, modifier 57 is placed on E/M. You cannot bill keeping the patient overnight if an outpatient procedure and no complications documented. It is very difficult to give an accurate opinion based on information provided.

More Info

The patient had his thyroid removed with no complications and has Geisinger insurance. SPU stands for short procedure unit (sorry I'm used to using it.) The patient was seen by the surgeon in recovery but not in the room he was only attended by residents. Hope this helps.

I agree with Nancy

I am sure the surgeon saw the patient in the office prior to the surgery so that is the consultation. On Post-op days, the surgeon or surgical residents cannot bill for visits as they are part of the global, but an internist or endocrinologist could bill for visits. The first visit would be a consultation with the outpatient codes and the subsequent visits would be subsequent outpatient visits.
Thyroidectomy is not an "Inpatient Only" surgery if done by the standard approach so if the patient was kept for patient/surgeon convenience then the hospital cannot bill for Observation or Inpatient care. I assume that is what your SPU is for-outpatients kept overnight- we call it Extended Recovery. If the patient was still in the hospital on post-op day 2, then perhaps Inpatient care is warranted when the patient's condition changed and an order for such should have been writen- perhaps they developed hypocalcemia.

Thanks

Thank you so much signature doc!