1) Does the entire documentation support modifier 22? Did the physician indicate complications or any indication that this was over and beyond the norm? If he/she has thorough documentation to warrant 22, it could be justified.
2) The harvesting of the flap..."A bifrontal periosteal flap was
harvested for later use. Bur holes were made. A bifrontal craniotomy was
performed."-I guess my question is...was the flap transferred back to the same site?
3) Titanium Mesh...My first thought was a cranioplasty (in addition to 62010) but then I discovered that a cranioplasty code is not assigned for replacing the bone flap after a surgical procedure (example, after a craniotomy bone flap replacement - titanium mesh plating system); which leads me to believe that this is inclusive to cpt code 62010.
Is there anyway you can post any additional information for this op note?
Does anyone else have any thoughts on this???
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