Wiki Reduced services AND unusual procedural services (-52 and -22)

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Anchorage, Alaska
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I am in a bit of a quandary. My surgeon performed a total proctectomy abdominoperineal approach on a patient with a new diagnosis of primary rectal CA. There was extensive adhesiolysis required to support the use of modifier -22.

Two years ago, this patient had a primary sigmoid CA removed by sigmoid colectomy with a permanent colostomy.

The correct CPT code for this, as documented, would be 45110 with -52 since the colostomy was not performed.

So, my quandary is - is it appropriate to use both modifier -52 and -22 on one line item? They effectively cancel each other out - for payment purposes.

TYIA,
Karen
 
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