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Thread: Seperate Procedure Confusion ?

  1. #1

    Question Seperate Procedure Confusion ?

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    Would the use of CPT code 27685 lenghtening or shortening of tendon (seperate procedure) be allowed with repair of a tear of the Achilles tendon CPT code 27650? The surgeon brought patient into OR to lengthen Achilles tendon for gastroc soleus equinus, upon exposure of the Achilles a tear was found & repaired, along with the lengthening.

    I have read the CPT code book on the definition of a "seperate procedure" and am confused by statement "however when a procedure or service that is designated as a seperate procedure is carried out independently or considered to be unrelated or distinct from other procedures/service provided at that time, it may be reported by appending the 59 modifier." Would this be a scenario that allows for 27650 to be assigned. The procedure was done in the same area/same incision. I have asked my supervisor for her interpretation & was informed I would only used 27685 however would like clarification of my confusion.

    Thank you
    Jody

  2. #2
    Join Date
    Apr 2007
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    Quote Originally Posted by Jody Hecht View Post
    Would the use of CPT code 27685 lenghtening or shortening of tendon (seperate procedure) be allowed with repair of a tear of the Achilles tendon CPT code 27650? The surgeon brought patient into OR to lengthen Achilles tendon for gastroc soleus equinus, upon exposure of the Achilles a tear was found & repaired, along with the lengthening.

    I have read the CPT code book on the definition of a "seperate procedure" and am confused by statement "however when a procedure or service that is designated as a seperate procedure is carried out independently or considered to be unrelated or distinct from other procedures/service provided at that time, it may be reported by appending the 59 modifier." Would this be a scenario that allows for 27650 to be assigned. The procedure was done in the same area/same incision. I have asked my supervisor for her interpretation & was informed I would only used 27685 however would like clarification of my confusion.

    Thank you
    Jody
    codes designated as "separate procedures" - they are telling you that these codes can only be billed if they are a "separate procdure" meaning separate incision, excision, different body part..or it is the only procedure being done.

    these codes are considered "integral" components to other procedures so they are considered included, it is cpt's bundling. So yes i would agree you can only charge for one. I guess your supervisor is consdidering the repair incidental?

    Hope that helps a little

  3. #3

    Default

    Thank you for your response, I now finally get it.

  4. #4

    Default Spell Check - "seperate" vs. "separate"

    Quote Originally Posted by Jody Mortensen View Post
    Would the use of CPT code 27685 lenghtening or shortening of tendon (seperate procedure) be allowed with repair of a tear of the Achilles tendon CPT code 27650? The surgeon brought patient into OR to lengthen Achilles tendon for gastroc soleus equinus, upon exposure of the Achilles a tear was found & repaired, along with the lengthening.

    I have read the CPT code book on the definition of a "seperate procedure" and am confused by statement "however when a procedure or service that is designated as a seperate procedure is carried out independently or considered to be unrelated or distinct from other procedures/service provided at that time, it may be reported by appending the 59 modifier." Would this be a scenario that allows for 27650 to be assigned. The procedure was done in the same area/same incision. I have asked my supervisor for her interpretation & was informed I would only used 27685 however would like clarification of my confusion.

    Thank you
    Jody
    Please use spell check -- part of being professional is first presenting a professional image -- "separate" procedure. We don't want anyone to think our certification is an easy one to obtain. thanks -Nancy

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