I have a case for a radical excision of an anterior chest wall, chondrosarcoma w/ resection of the sternum w/ resections of the costochondral head of all of the ribs along with resection of a mediastinal chondrosarcoma w/ debridment of the tumor off the internal mammary artery and resection of chondrosarcoma from the pericardium and epicardium.

This patient has a large anterior chest wall chondrosarcoma involving the sternum and the epicardium and pericardium.
Here is my dilemma, my surgeon did this above procedure and then assisted the plastic surgeon on another procedure. I called the plastics billing person, so we could bill the same codes for the assistant portion and I do not agree with the codes he gave me. He billed code 21600 a total of 19 times with a 59 modifier! There is a code 19620 that is for excision of chest wall tumor including ribs. He also said I should bill the following codes, 21630, 21558, and 33130. I do not agree with any of this but am stuck because we have to bill the same codes as the primary surgeon on the assist portion to get properly paid.
I hope Lisi is out there and reads this. She is very good woth cardiothoracic coding.
If there is anyone out there, I can email this case to take a look at (HIPAA compliant, of course) please let me know as soon as possible! There is more to this case than what I was able to post on this thread.


Kristin Felty CPC, CCC, CCVTC