CPT 21453/21462 same surgery session

stannler

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Loveland, CO
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I am new to ENT and have a fractured mandible procedure I am coding. Pt has an open fracture on one side and a closed fracture on the opposite side of the mandible. Both procedures were performed during same surgery session each with inter dental fixation. I wanted to confirm that both procedures can be billed, also I assume a -51 modifier be used for the lower RVU procedure? I would appreciate any feedback. Thank you. Sean
 
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Chiefland, FL
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Sean, did you ever figure this out? I'm a new coder for oral surgeries and having the same issue. I did use -51. My 21453 is still always denied and only the open procedure (21462) paid. When I call insurance to explain there is a right, left, and center area of the mandible that may need to be treated, I get the response that "it's one bone" and I can only code the open procedure. I have even tried adding additional information above the code for the location of the treatment (ie: right mandibular condylar fx, mandibular symphysis fx, etc.). Any help is greatly appreciated! Jennifer
 
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