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Wiki mitral repair turned mitral replacement

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rufus

Networker
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Elkhart, IL
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Hello,
My physicain did a mitral repair (33426) this was not felt to be sufficient so he took down the repair and did a mitral replacement with a prosthesis (33430). He is wanting to bill the 33426 with a 53 and also bill the 33430. He did do a lot of work. My first instinct is to say no he can not do this. But I thought I would get some expert opinions.
Any help is appreciated!!!
 
You cannot bill both, even with the modifier. They will hit CCI edits. You can add the 22 modifier for the extra work. I have had this before.
 
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