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Excision of chest wall tumor

  1. #1
    Richardson, TX
    Default Excision of chest wall tumor
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    I am new to surgery coding and want to be sure I am on the right track here.

    My physician did an excision of chest wall tumor with partial sternectomy.

    "A chest wall recection was performed, excising a portion of the manubrium and the body of the sternum. The ribs were resected as well with a margin laterally and inferiorly. The chest wall was then reconstructed using prolene mesh in 2 layers. The incision was then closed using 3-0 Vicryl interrupted suture...."

    My research led to CPT code 19260. The office is questioning if there should be a seperate code for access. I say no because the opening and closing is included; like with heart caths, the primary code includes the access and you can't bill for closure.

    Would there be another code allowed? Please advise! Thanks a million!
    Julie Graham, BA, CPC, CCC

  2. #2
    Fayetteville, NC
    I believe they are thinking you should be billing for the partial sternectomy too. There are no bundling issues for the two codes BUT it really all depends on what the OP note says.
    If the partial sternectomy was the approach (required to perform the procedure) it may not be billable. Like I said it all depends on what is in the OP note.
    Maybe if you posted the OP note (with all personal and identifying information removed) we could help you decide if the code for the sternectomy is appropriate as well
    A. McCormick, CPC, CGSC
    Walters Surgical Associates

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