Wiki Help - autotransplantation

[Earnose]

One of our Doc's coded a surgery the other day as follows,
60220-total lopbectomy,unilateral w/woisthmusmuetomy

60512-parathyroid autotransplantation

sorry i do not have op note yet.

My claim is holding because 60512 is not being billed with the appropriate primary procedure. He is insisting this is how it has to be billed.
Any suggestions. Please

 

[jackjones62]

He maybe insisting it be billed, but he is incorrect, you cannot bill CPT 60220 and +60512 together according to CPT guidelines as well as CCI Edits; there is a parenthetical statement below CPT 60512 that instructs you on what codes this can be billed with. I understand his plight, as I just billed out the same scenario; if you read the definition of parathyroid autotransplantation it tells you that all 4 of the parathyroids are removed and 1/2 of one gland is transplanted either in the sternocleidomastoid muscle or upper arm somewhere; if I were to take a guess at what your surgeon did, he removed either the right or left lobe and with it a parathyroid and transplanted it in the sternocleidomastoid muscle to salvage it. If your surgeon feels he did more than CPT 60220 describes you can certainly addend with Modifier 22 showing increased procedural services.

Hope this helps.

Jennifer
ENT CT