Medically Unlikely Edits (MUEs) may render certain claim lines for bilateral surgical procedures unpayable, and the Centers for Medicare & Medicaid Services (CMS) has expanded its instructions to make it all a little more clear. MUEs and the Bilateral Surgery CMS points out in MLN Matters SE1422 Revised that providers and suppliers billing bilateral procedures using […]
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Tag Archives: Bilateral
Bilateral Salpingectomy for Sterlization
Provider’s operative report indicates "bilateral partial salpingectomy" which would be billed with 58661 and the diagnosis was sterilization. Can this code be used or does 58670 cover this as the distal portion of the tubes were removed.
Thanks
Bilateral TAP blocks AND Bilateral Rectus Sheath blocks duting same session
Hi,
Provider performed both Bilateral TAP blocks single injections, and Bilateral Rectus Sheath Blocks, single injections. Has anyone had any experience coding for both and not getting it denied?
how would it be billed? 64488-XE, 64488-59 ?? Keep in mind this will be billed w/ 00752 as well.
Thanks,
Ellie
52005 Bilateral
So CPT 52005 does not qualify for the -50 modifier. How should the procedure be coded when a provider performed it bilaterally.
The patient was then brought to the operating room and placed in the dorsal lithotomy position. She was prepped and draped under the usual sterile technique. A 22-French cystoscope was used to evaluate the patient. The anterior urethra was normal in appearance without any evidence of stricture. Upon entering the bladder both ureteral orifices were identified, appeared to be in orthotopic position, with clear efflux urine. Systematic
evaluation of bladder with a 30 and 70-degree angle lens demonstrated no gross intravesical pathology specifically no gross inflammation, tumor, or calculi.
*
A 5-French end-hole catheter was placed in the right ureteral orifice. A right retrograde pyelogram under real-time fluoroscopy demonstrated no gross static filling defect or obstructive uropathy. Subsequently, a left retrograde pyelogram was performed. This demonstrated no gross static filling defect or obstructive uropathy. At this point, then the bladder was filled to capacity. The cystoscope was withdrawn. On pelvic examination, she was noted to have urethral hypermobility, POP-Q stage I, anteroposterior compartment prolapse. There appeared to be she has had previous hysterectomy, good support of the vaginal wall.
Thank you for the help!!!
Billing for Bilateral Facet Fusion
Can a 50 modifier be appended to CPT code 22600 for Bilateral Facet Fusion?
Bilateral procedure- one side discontinued
I’m hoping to get an opinion on the correct coding for this. Physician performed 64483 bilaterally on one level, however, had issues and could not complete the left side. It was billed as 64483-RT, 64483-53-59-LT. Medicare paid the right side, but denied the left as information submitted does not support this many/frequency of services. Documentation was sent, but it still denied.
I thought about changing the left to 64484-53-LT, although the definition of 64484 is for each additional level and this was the same level as the right side. The only other thing I can think of is to bill the bilateral as 64483-53-50, but I wasn’t sure if the completed side would get paid at the full rate if I do this.
Thanks!
Susan
Exc Bilateral Breast Accessory
Hello,
Looking for a CPT Code for Excision of Bilateral Breast Accessory please. Thanks
Looking for a CPT Code for Excision of Bilateral Breast Accessory please. Thanks
Bilateral mastectomies Mod 58 or 79
RT mastectomy performed on 1 date.
LT mastectomy performed on another date. Modifier 58 or 79?
Debridement and Secondary complex closure of wound dehiscence of bilateral breasts
Assistance needed in coding this case for our ASC.
The physician wants to code as 11010 X 2 & 13160 X 2; however, those codes bundle leaving us with just 13160 as the procedure was performed in the same anatomical site.
My question is, would it be appropriate to code 13160 and 19340 LT for the extra work that went into the left side with the implant being removed, cleaned and replaced?
Pre/Post Op Dx: Bilateral incisional dehiscence of breast reconstruction, status post bilateral mastectomy and immediate reconstruction.
Procedures Performed:
1. Debridement of bilateral breast
2. Secondary complex closure of wound dehiscence of bilateral breast
Indications and Findings:
Patient approximately one month status post bilateral mastectomy and immediate reconstruction using AlloDerm and a permanent implant. Today in followup, she was noted to have dehiscence of her incisions bilaterally. On the right, she remained with viable muscle at the base of her dehiscence; however, on the left, there was exposure of her underlying AlloDerm, and is now returned to the operating room for a secondary closure and attempted salvage.
On the right, the patient was noted to have incisional dehiscence; however, the pectoralis muscle remained viable at the base of the wound. There was no evidence of purulence. On the left, there was exposure of the underlying AlloDerm covering the implant. However, again, there was no evidence of purulence or significant infection. On the left, the wound was initially profusely irrigated with a Pulsavac irrigation system. The implant was then removed, and the entire wound again thoroughly irrigated, and the implant was soaked in Betadine for approximately 25 minutes. The implant was replaced and the wound secondarily approximated as described below.
Description: After anesthesia, the left breast wound was then cultured following which the anterior chest wall was prepped and draped in the usual sterile fashion. Nonviable tissue along the margins of both incisions were sharply debrided. Both wounds were then irrigated with the Pulsavac irrigation system using a betadine saline solution. On the right, the patient was noted to have viable pectoralis muscle at the base of the area of dehiscence; however, on the left, there was exposure of the acellular dermal matrix. The matrix was transected at the area of dehiscence and the implant removed. Again, there was noted to be no evidence of any purulence whatsoever within the pocket. The implant was completely submerged in a betadine solution following which the pocket on the left was again irrigated with a Pulsavac irrigation system. The entire operative field was then broken down and reprepped and draped in the usual sterile fashion. The pocket on the left was then again irrigated with 3 liters of a betadine/saline solution following which the implant was replaced within the pocket. The dehiscence was then approximated using interrupted sutures of 3-0 Vicryl to approximate the acellular dermal matrix in deep subcutaneous tissues. The wound was again irrigated with the Pulsavac irrigation system and the skin approximated using interrupted horizontal mattress sutures of 3-0 Prolene. On the right, the wound was reapproximated using interrupted horizontal mattress sutures of 2-0 Prolene. A sterile dressing consisting of xeroform gauze and Tegaderm was applied following which the patient was taken to the step-down unit in stable condition. All counts were correct. There were no complications.:confused::confused:
Bilateral Hernia repair with and without gangrene
Bilateral inguinal hernias: Left side with gangrene and obstruction, Right side without gangrene and obstruction
Should the surgeon report the surgery single line with a mod 50 or should they report the procedure with two lines: LT first dx and RT second dx?