Wiki Unbundling

[carol52]

Cpt codes 47600 Open chole and 49566 incis hernia repair. According to ACS coding medicare will not allow because of unbundling. can a 59 modifier be justified because of 2 different sites or procedures ? Any expert advise ? There was not a second incision made.

 

[LLcoder]

I'm not really familiar with this, but it seems to me that one time while I was reading through some things that the hernia repair can be part of that open procedure. Was there a separate incision for the hernia repair? This will give me something else to read up on.

 

[DVoyles]

It depends if it was a separate incision or if the hernia was at the incision site. If he made a separate incision you can unbundle it w/ a -59, otherwise it would be included in the procedure.