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Hernia repairs with Excision of leasion of spermatic cord

Reenie98

Contributor
Messages
20
Location
Columbus, Ohi
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Hello!
When billing for an inguinal hernia repair (49505), if a physician performs a spermatic cord lesion removal (55520) Is it ALWAYS separately reported with a 59 modifier.

I know there is a CPT assistant (Sept 2000 page 10) that states:

AMA Comment: Code 55520, Excision of lesion of spermatic cord (separate procedure), is designated as a ?separate procedure.? Codes with the ?separate procedure? designation normally would not be additionally reported when the procedure or service is performed as an integral component of another procedure or service. However, when codes designated as ?separate procedures? are performed independently, unrelated or distinct from other procedure(s)/service(s) provided, then it would be appropriate to separately report the separate procedure.

Modifier ?-59,? Distinct Procedural Service, would be appended to code 55520 to indicate that the excision of the spermatic cord lesion is a separate, distinct procedure from the inguinal hernia repair performed at the same surgical session.

My question is, does this mean we can separate EVERY spermatic cord lesion? And if that is the case, Why do they bundle?
 
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