Cpt code 48140 and 38100

stheck

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There is a CCI edit, which means that the 38100 (biopsy) is included in the 48140. The only way to bill both is if they are for different sites. In that case, a modifier should be used.
 
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Modifier "allowed" does NOT mean Modifier "appropriate"

Further information from Encoder Pro - Coding tips for CPT 48140
Splenectomy, when performed is included in these procedures and should not be reported separately. If significant additional time and effort is documented, append modifier 22 and submit a cover letter and operative report.

A modifier is allowed, but that does not mean it is appropriate. The documentation must support the use of the -59 modifier.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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