Wiki 2 segments on path report coded as 2 x 21556?

[wynonna]

Per path: 2 portions of mass, 1 anterior to vein, and the other posterior to vein were excised. 2 pieces with different dimensions, different depths were excised. They total 4.1 cm. Do I bill each individually twice for 21556, and 21556 with mod 59/XS? Or do I bill 21556 once for 4.1 total for 2 pieces?

 

[thomas7331]

If it's a single mass at the same site approached via the same incision, then it should only be billed once. If documentation suggests that the nature of the site and location around the vein created significant additional work, then I would add modifier 22.

 

[jackjones62]

Per path: 2 portions of mass, 1 anterior to vein, and the other posterior to vein were excised. 2 pieces with different dimensions, different depths were excised. They total 4.1 cm. Do I bill each individually twice for 21556, and 21556 with mod 59/XS? Or do I bill 21556 once for 4.1 total for 2 pieces?

If they came from the same incision and are part of one mass you bill 21556 once. Also note, you cannot code from the pathology report, just FYI.

Jennifer
Coding Analyst

 

[wynonna]

thank you both!