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Wiki help needed on this op note

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freespririt0806

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4387

I am thinking of the following codes, thank you in advance
14060
69145 RT
12052
 
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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 . :)
Click to expand...

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.
Click to expand...
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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