My provider performed a right ankle arthrocentesis (20605) and right ankle arthrotomy (27620) during the same operation. CPT 27620 was the only code billed as there is a CCI edit between 27620 and 20605. The provider is saying that the arthrocentesis was performed in order to decide whether or not to perform the arthrotomy. He feels that 20605 should be coded and billed with a modifier 59.

Does the above scenario qualify as a ‘Distinct Procedural Service’ and does it justify appending modifier 59 to 20605?
Or would this be a diagnostic/surgical scenario? For instance, we wouldn’t code a diagnostic laparoscopy if performed in conjunction with a surgical laparoscopy..

Thanks in advance.