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Bilateral Coronal Synostosis

Deborah h Posted Tue 28th of July, 2015 12:17:05 PM

In coding a Bilateral Coronal Synostosis; would you code 61550, 61550-59 or would you code 61552. It the physician did two separate coronal synostosis; single burr hole was made for the right coronal suture and a single burr hole was made for the left coronal suture. CPT code 61550, Medicare MUE is one per day. Please, when you answer this question; please list some type of reference or documentation to back up your answer.

SuperCoder Answered Wed 29th of July, 2015 00:01:14 AM

You should use CPT code 61552 x1 unit only. Currently we do not have any proper reference for this code. But we do have a similar scenario for your reference.

Question: Is it appropriate to report 61558 more than once per session, perhaps by applying modifier 59 to the second unit?

Missouri Subscriber

Answer: Code 61558 (Extensive craniectomy for multiple cranial suture craniosynostosis [e.g., cloverleaf skull]; not requiring bone grafts) describes release of multiple, typically bilateral, prematurely fused sutures.

Because the code descriptor specifies both "extensive" and "multiple," this is a "once per session code." You would not report multiple units of 61558 per session, either with or without modifier 59 (Distinct procedural service).

The above question is for the cases which requires extensive craniectomy, but it is similar to your case as well.
Please find below the link for this reference.
https://www.supercoder.com/coding-newsletters/my-neurosurgery-coding-alert/reader-questions-limit-61558-to-once-per-session-article

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