CABG/Internal sternal plate closure

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On morbidly obese patient's my surgeon will close the sternum sometimes with internal sternal fixation with Biomet microfixation sternal lock blue plates after a CABG or valve replace/repair procedure. Am I thinking correctly that this complex closure of the sternum
is bundled in with the CABG and valve codes?? If I am wrong in my thinking can someone advise me on how to code for this type of closure? Thx!! :confused:
 

ABridges

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Because this is a more extensive repair than what is usually required, it should not be bundled with the CABG codes. I was advised by our coding consultant to use 21825 to code these and no modifier is necessary. I always send in the op note with the claim when I use this code and I have never had a problem.
 
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Thx!

Thanks soooooooo very much for your help on this!! I actually did more research and came up with the 21825 code. Not sure I understand why there is no need to append a modifier though... I was thinking 22 and 51 would be appropriate??
 

ABridges

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You can append the 51 modifier, but if you don't the insurance company will do it for you. I have never used the 22 on these because adding the 21825 code describes the additional work that was done. I don't really think it would be wrong or right to add the 22. Does that make sense?!
 
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