Good morning,
A physician billed out codes 56620 & 15839 together. The 15839 was denied for no auth, and now our follow-up department has to appeal. They've asked me to review the op note first and I'm a little stumped. I do not see a CCI edit for these two codes, and it does look like he did both, per the report. I'd like another set of eyes, if anyone can assist/guide me. Pathology came back as positive for VIN I.
"Kelly clamps were place at the longest portion on the labia minora bilaterally to demarcate the area to be excised. Excess labia minor tissue was removed with scalpel bilaterally. Figure of 8 2-0vicryl sutures were placed to re-approximate skin edges, with hemostasis notes.
Excess vaginal tissue was identified in circumferential fashion at the level of hymen ring, where the chronic inflammation and pain was noted, the tissue was removed with Metzenbaum. Vaginal tissue edges were re-approximated with 3-0 Vicryl running and figure of 8 suture.
Attention was then turn to the perineal regimen, where the patient also report pain pre-operatively. A diamond shaped incision was made at perineum and skin was genteelly trimmed with scalpel. The incision edge was reapproximated with 2-0 vicryl in a running fashion, the crown stitches was used to ensure the adequate closure of deadspace and perineal tissue. Sub-cutaneous suture was done to reapproximate the incision, and vaginal packing placed.
Vaginal caliber was then tested to ensure there is no significant narrowing of her vaginal opening, and excellent hemostasis is maintained." She then goes on the apply Marcaine, straight cath, etc..
Thank you
Kathleen
A physician billed out codes 56620 & 15839 together. The 15839 was denied for no auth, and now our follow-up department has to appeal. They've asked me to review the op note first and I'm a little stumped. I do not see a CCI edit for these two codes, and it does look like he did both, per the report. I'd like another set of eyes, if anyone can assist/guide me. Pathology came back as positive for VIN I.
"Kelly clamps were place at the longest portion on the labia minora bilaterally to demarcate the area to be excised. Excess labia minor tissue was removed with scalpel bilaterally. Figure of 8 2-0vicryl sutures were placed to re-approximate skin edges, with hemostasis notes.
Excess vaginal tissue was identified in circumferential fashion at the level of hymen ring, where the chronic inflammation and pain was noted, the tissue was removed with Metzenbaum. Vaginal tissue edges were re-approximated with 3-0 Vicryl running and figure of 8 suture.
Attention was then turn to the perineal regimen, where the patient also report pain pre-operatively. A diamond shaped incision was made at perineum and skin was genteelly trimmed with scalpel. The incision edge was reapproximated with 2-0 vicryl in a running fashion, the crown stitches was used to ensure the adequate closure of deadspace and perineal tissue. Sub-cutaneous suture was done to reapproximate the incision, and vaginal packing placed.
Vaginal caliber was then tested to ensure there is no significant narrowing of her vaginal opening, and excellent hemostasis is maintained." She then goes on the apply Marcaine, straight cath, etc..
Thank you
Kathleen