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25605 with 76000

  1. #1
    Question 25605 with 76000
    Medical Coding Books
    Auditing charges in our ortho department and am stumped.
    One of our managers coded 25605 with 76000 modifier 26. I though that 25605 included procedure 76000 so my thought was this is incorrect and only 25605 should be billed. Our PMS has code correct and when I performed the code check on this it stated that 25605 can be used if a modifier 59 is used.

    My question is why code for it if it is already included in the primary procedure code?

    Any thoughts would be greatly appreciated!
    Be Blessed!
    Zaida D. McGarry, CPC

  2. #2
    You are right--it is considered part of 25605. The 76000 bundles with the 25605. By adding the 59 modifier she is unbundling. (unless of course the fluoro is on a different body part other than the fracture)

  3. #3
    It is the same body part. Thank you for your quick reply!
    Be Blessed!
    Zaida D. McGarry, CPC

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