Wiki Pleurodesis with drainage of effusion

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Costa Mesa, CA
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I have a provider who wants to add modifier 22 for draining a pleural effusion at the time of doing a pleurodesis. I don't see it documented that there was increased work, complexity, or time and the office manager is pushing back. Please see the below op note snip and all feedback is welcomed and appreciated!

"An incision was made about the 7th ICS in the posterior axillary line. A thoracic port was placed. The camera was introduced. There was a large amount of clear serous effusion within the chest 2.6 liters was evacuated. No masses were found on the lung or chest wall. 8g of talc powder was instilled into the chest using a clean septa syringe. 28fr CT was placed through the incision and secured to the chest wall. The incision was closed."

It's my understanding that the code for draining an effusion is 32601, which is bundled into 32650 for the pleurodesis and I don't see support of modifier 22. Thank you in advance!
 
I agree with you just code the 32650 unless he amends how much time removal of 2.6 took and why it was complex or necessitates use of increased service.
As the use of mod 22 will flag for audit and OP note needs sent.
 
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