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Tiaralady6466, the excision of a lesion that creates the defect that an adjacent tissue transfer repairs is considered incidental to the ATT. Although 69145 is not bundled with 14060, I would not code it since the ATT is repairing the defect created by the 69145, and the ATT (14060_) has more RVUs.

I would code the repair of the defect created by the ATT, but that repair is bundled into the ATT, so you would need an XS modifier (or a 59 for payers who do not recognize the X[ESPU] modifiers) to indicate that it was performed at a different site. I recommend using the XS whenever you can because payers are looking at the use of the 59 modifier for distinct procedural service. Using the X[ESPU] modifiers tells the payers that you reviewed the documentation and checked it to insure that the distinct procedural service is supported.
 
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Thank you Barbara, i do know that the exicision is included in the ATT, but i did not realize that included codes other that the typical lesion excision codes. Thank you for your clarification . :)
 
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tiaralady6466 said:
Thank you Barbara, i do know that the exicision is included in the ATT, but i did not realize that included codes other that the typical lesion excision codes. Thank you for your clarification . :)
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Thank you Barbara,
i do know that the exicision is included in the ATT, but i did not realize that included codes other that the typical lesion excision codes. Thank you for your clarification .
:)
 
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Actually, you made me go back to my cpt manual and do another look, Tiaralady6466.
It specifically states:
"The excision of a benign lesion (11400-11446) or a malignant lesion (11600-11646) is not separately reportable with codes 14000-14302."

So by strict reading of this 69145 (Excision soft tissue lesion, external auditory canal) would be coded and billed. I just felt that 69145 is not really different than excision of benign lesions, except it is specific to the anatomy. Let me do a little more research. It may be billable.
 
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After reviewing the notes in the ATT section, and discussing this with some other Oto coders that I network with, I have decided Tiaralady6466 that 69145 can also be coded and billed because it is not just a skin lesion excision as indicated in the instructions as included in an ATT. Sorry for the misdirection earlier. We are all always learning.
 
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b.cobuzzi said:
After reviewing the notes in the ATT section, and discussing this with some other Oto coders that I network with, I have decided Tiaralady6466 that 69145 can also be coded and billed because it is not just a skin lesion excision as indicated in the instructions as included in an ATT. Sorry for the misdirection earlier. We are all always learning.
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Thank you Barbara, and yes we are always learning
 
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I love reading all these cooperative coding experiences! I can just see how we get drawn in to finding the solution and don't give up until we're satisfied!! Well done discussion and clarification guys!
 
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