Results 1 to 3 of 3

Tracheostomy - My ENT did a Tracheostomy

  1. #1
    Location
    Daytona Beach, FL
    Posts
    752
    Talking Tracheostomy - My ENT did a Tracheostomy
    Medical Coding Books
    My ENT did a Tracheostomy with fenestration and skin flaps (31610) but he also wants to bill 60200 for the division of the thyroid isthmus. Can these be billed separately or is the division of the isthmus part of the 31610? I have checked CCI edits and they don't hit any edits, but the lay description of 31610 says "the thyroid isthmus is cut if necessary" so I am confused as to whether the 60200 would be billed. The note is below.

    The neck was sterilely prepared and
    draped and a shoulder roll was placed. A 2 cm horizontal incision was created
    in the midline anterior neck. Additionally, the scar of the initial
    tracheostomy was resected as an ellipse. Dissection was carried down through
    the strap muscles, and a remnant of the thyroid isthmus was identified and
    divided. The previous tracheostomy tract was identified, and a new incision
    was made through tracheal scar tissue from the previous tracheostomy. This
    preexisting tracheostomy tract was then widened and the intubation tube was
    removed. A #8 Shiley cuffed tracheostomy tube was placed and the cuff was
    inflated. The previously created inferiorly-based tracheal flap was then
    secured to the skin with suture and tape. Vicryl sutures were then used to
    close the tracheostomy incision and silk sutures were used to secure the
    tracheostomy tube to the patient's neck. CO2 return had been confirmed and
    the ventilator was attached.

    Any suggestions are greatly appreciated!

    Thanks,
    Jodi Dibble, CPC

  2. #2
    Default
    In my opinion I would not bill 60200, feeling that it would be included in the trach procedure. In this case it looks like there was a previous tract for this procedure and that it was only a remnant of isthmus left identified makes me think the isthmus was divided in a previous surgery anyway. I just don't see how you could prove it was medically necessary to bill it. Hope this helps!
    A.Dimmitt, CPC, CIRCC
    Durham, North Carolina

  3. #3
    Location
    Daytona Beach, FL
    Posts
    752
    Default
    Quote Originally Posted by dimmitta View Post
    In my opinion I would not bill 60200, feeling that it would be included in the trach procedure. In this case it looks like there was a previous tract for this procedure and that it was only a remnant of isthmus left identified makes me think the isthmus was divided in a previous surgery anyway. I just don't see how you could prove it was medically necessary to bill it. Hope this helps!
    Yes that does help! I don't think he should be billing the 60200 because when I look up the lay description for the Tracheostomy it states the isthmus is cut if necessary - but I was not sure if that was the same thing as a "transection of the isthmus" as it describes in the code 60200. He did 3 of these procedures last week and this was the only one where he mentioned that it was a remnant of isthmus (I didn't realize this was the OP note I had chosen - not a good example ).

    Thanks for you help!
    Jodi Dibble, CPC

Similar Threads

  1. Tracheostomy help Please
    By bill2doc in forum General Surgery
    Replies: 1
    Last Post: 12-31-2012, 08:54 AM
  2. Tracheostomy
    By dpumford in forum Cardiovascular Thoracic
    Replies: 2
    Last Post: 12-12-2011, 12:50 PM
  3. Tracheostomy - How would I code a tracheostomy
    By SLELISON in forum ENT/Otolaryngology
    Replies: 0
    Last Post: 07-08-2011, 09:16 AM
  4. tracheostomy-please help
    By NJcoder in forum Diagnosis Coding
    Replies: 0
    Last Post: 12-18-2008, 09:47 AM
  5. tracheostomy
    By NJcoder in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 12-11-2008, 04:53 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.