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Wiki 26116 & 26080?

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codinggal

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Peoria, AZ
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Hello! I often have a case where a provider is requesting 26116 & 26080. I don't believe both should be coded as there is an NCCI edit but I am looking for others to chime in with their knowledge. I appreciate any feedback. Thank you.
Preop/Postop dx: Left index finger deep dorsal mass, 4mm, Left index finger DIP joint arthritis with loose body
"An incision was then made dorsally, centered about the mass and underlying distal interphalangeal joint. After sharply incising the skin, care was taken to elevate thick skin flaps. The underlying deep mass was identified and excised fully from the surrounding deep soft tissues coagulating vascular feeders to the mass with electrothermal cautery bipolar. Once the mass was fully excised, the extensor tendon was mobilized carrying out a dorsal arthrotomy where a synovectomy was carried out with a bony rongeur also removing an underlying loose body."
 
These appear to be separate procedures and would be billable in a non-CMS patients with a -59 modifier.
Unclear whether the mass was related to the DIP arthritis, but your surgeon was appropriately vague and gave you separate diagnoses, so you kinda have to follow that lead.
N.
 
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