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Wiki Coding Adenoidectomy and Tympanostomy Together

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lbusby2

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Okay, I need some help. Should their be a modifier attached to the 69436, other than bilateral when these are done at some surgical session?

42830 (Adenoidectomy)
69436-50 (bilateral Tympanostomy (requiring insertion of ventilating tube).

Problem: EncoderPro says need modifier 51 to 69436, but these are 2 different organ systems, so wouldn't 59 be more appropriate.

Also, if you go to CMS CCI code edits, these 2 are not listed together?

Help. Claim is being denied when modifier 59 is being added to 69436.

Please add rationale..Thanks
Lynn
 
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