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Wiki Cpt 25320 ?

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rbynmnk

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:confused:Hi, my doc's are currently coding ligament repairs with CPT 25320-
Capsulorrhaphy or reconstruction, wrist, any method (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability. We bill one for each ligament we repair because it does not state "all" and I can not find anywhere that states we can not bill for multiples of this code, we are billing each additional coded with a -51 mod and -59 to state that we are in agreeance that this is the same procedure in the same area many times but it is documented that they are seperate structures...how ids this any different than billing for multiple tendon repairs?

We are starting to be denied reimursment for all but one code per day, their reason is if you have one or four ligaments repaired this can only be represented by one code one time....doe anyone have documentation or insight to either side of the argument? please help!!!
 
I looked this up on the Medically Unlikely Edits and it is saying only 2 units per practitioner and that appears to be RT and LT.

It looks to me like you only get 1 unit per side no matter how many ligaments are repaired.

Laura, CPC
 
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