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59 Modifier conflict

Amy Posted Thu 28th of November, 2019 04:11:03 AM
Provider A perform EGD tube placement (43246) and tracheostomy placement (31600) and Provider B performs Bronchoscope (31622) with PEG tube (43246). can we give 59 modifier to 31622 in this scinario. please advise.
SuperCoder Answered Fri 29th of November, 2019 06:44:59 AM

Hello Amy,

Thank you for your question.

 

NCCI version 25.3 bundles CPT® code 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure) into CPT® code 31600 Tracheostomy, planned (separate procedure).

This bundle, however, has a "1" in the modifier column. This indicates that you can append modifier 59 (Distinct procedural service) to unbundle these procedures, as long as it is medically necessary to provide each service, and your documentation supports two separate services (e.g., when the pulmonologist performs a bronchoscopy on the patient earlier in the day).

 

Hence, you can append modifier 59 with CPT® code 31622 for procedure performed by provider B.

 

For more information, kindly go through the under-mentioned link. Do let us know, in case you’re unable to access the newsletter.

https://www.supercoder.com/coding-newsletters/my-pulmonology-coding-alert/reader-questions-lay-out-the-right-bronchoscopy-code-for-31600-article

 

Hope that helps!

Thanks

Amy Posted Sat 30th of November, 2019 04:15:36 AM
thank you.
SuperCoder Answered Mon 02nd of December, 2019 01:43:02 AM

You are welcome.

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