Wiki 23620 denied

[coders_rock!]

Does anyone knoe if 23620 can be reported with 23600. CCI edit allows a modifier on 23600 but I do not want to put modifier 59 just because it is allowed.

Thank you...

 

[btadlock1]

Does anyone knoe if 23620 can be reported with 23600. CCI edit allows a modifier on 23600 but I do not want to put modifier 59 just because it is allowed.

Thank you...

Did the patient have multiple humeral fractures treated? As long as separate fractures at the proximal humerus and of the greater tuberosity are both documented, you should be okay using the 59 modifier. If these fractures were on different arms, though, you might be better off using LT and RT modifiers, instead. Hope that helps!

 

[OCD_coder]

I agree, the diagnosis will drive the CPT code selection and a mod-59 may be appropriate on the 23620. The 23600 is the comprehensive code and should be listed first.

Humerus Dx:
812.01 surgical neck
812.02 anatomical neck
812.03 greater tuberosity

23620 Closed treatment of greater humeral tuberosity fracture; w/o manipulation

23600 Closed treatment of proximal humeral fracture (surgical or anatomical neck
fracture); w/o manipulation