Billing and Coding Question


Surgery? Ethical Dilemma

What recommendation would you provide to the physician in your office?

The surgeon you work for in Nebraska has been asked to repair a colostomy for a patient who has applied for Medicaid insurance coverage in North Carolina. He currently came up to live with his sister in Nebraska so she could care for him.  He’s employed as a worker as a manual laborer back home.

The patient came to your office asking for the colostomy reversal.  You will not get paid from the insurance company as Medicaid will only pay for patients in their home state.  Since he is employed working as a manual laborer, he has not had income and can’t afford to pay for the repair. 

Do you perform the surgery for free or send the patient back to have the physician perform the original surgery in his home state where he will have insurance? What would be your recommendation and why?