Wiki Billing for 3rd chest tube


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I was informed that we could bill for a 3rd chest tube when placed during open heart surgery. However, I cannot find any information on this.

From what I understand, placing chest tubes in the mediastinum and pleural cavitiy is inherent in the procedure. But, if a 3rd pleural chest tube is inserted, that can be billed? Has anyone ever heard of this and if so, where could I find this in writing?

Thank you!
Two chest tubes are considered to be a "routine" part of a CABG or any other open heart procedure and are bundled with the other codes. Inserting a third chest tube for a pleural effusion would be considered outside of the norm, and can be billed with the appropriate modifier and diagnosis code.

It should, however, be documented in the operative note that the third chest tube was placed for the pleural effusion, or for whatever condition the surgeon felt the need for the additional chest tube.

Hope that helps.
Sorry, but could you explain to me what that means? Is it specific to certain MAC's? Is there anything I could download to prove this to my coding manager?