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Wiki HELP! MV repair followed by MV replacement

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jtb57chevy

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Raceland, KY
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It's Friday afternoon and my brain is a little mushy, so if the answer is obvious please forgive me....

Patient has MV repair with reconstruction-33427. Chest closed, weaned off bypass, things look good. But while still in the OR significant mitral regurg is discovered, so chest is reopened, patient is put back on bypass and a MV replacement is done - 33430.

Can I bill both? My claim edit software won't allow both charges, even with modifiers 59, 78 or 78 by itself.

Thankful for any help!
 
I had this same senerio with an AVR awhile back. I posted it on this forum and everyone suggested that I bill for the replacement. I decided to add a 22 modifier and sent the bill with the operative report to show that a repair was attempted.

HTH,
Dorinda
 
bill replcmt w/modifier 22

I would bill the replacement with the modifier to show the work done prior...you always have to go with the furthest treatment done on the body part.
 
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