21558 & 38724

jocoffey

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Hi,
Can anyone tell me if 38724- modified radical neck dissection is a integral part of procedure 21558-resection of of soft tissue tumor of

neck. We have received a denial on this, your assistance is appreciated.
 

thomas7331

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These two codes are designated as 'mutually exclusive' on the CCI tables, but do allow a modifier to override the bundling. So they shouldn't be billed together unless the documentation supports that they were separate and distinct procedures.
 
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