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Is there a separate code for this excision?

  1. #1
    Pensacola , Florida
    Default Is there a separate code for this excision?
    Medical Coding Books
    Hi there ! So happy its Wednesday

    My question:
    Is there a separate code for this :

    He preformed these 3 procedures :

    Carpal tunnel release 64721
    A1 pulley release right third finger 26055
    #3 ....
    then his notes say "Adjacent to the A1 pulley there was a cyst emanating from the A1 pulley. After complete excision the IP joint was noted to glide freely"

    I cannot find one ... Please help

    Thank you in advance

  2. Default Dawn, CPC
    In my opinion, 26160 would be appropriate as long as it is not inclusive of 64721 or 26055, which it might be.

  3. #3
    ASCExpert states that 26160 and 26055 cannot be billed together, but a modifier is allowed and supported by documentation.
    Last edited by bethh05; 05-13-2009 at 09:45 AM.

  4. #4
    Pensacola , Florida
    Default Using a -59 with 26160 ?
    Thanks to both of you ...but I need some clarity

    I did see that 26160 would be the correct code ...but if he was already doing the A1 Pulley incision ... and there was this cyst that ended up being excised ...then sutured closed ...all a part of the A1 26055

    You are right the edits say they cannot be billed together ...but a -59 is allowed ...

    Here is where I am confused -

    Can I rightfully use the -59 just because there was a cyst that had to be excised ?
    Even though only one incision and one suturing as part of the 26055

    I may sound dumb I agree ! but this is becoming clear as mud!

    Thanks for your help !
    Please help again

  5. #5
    In my opinion, the 59 modifier would not be justified for this particular scenario.

    Mary, CPC, COSC

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