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George Posted Tue 05th of December, 2017 12:08:44 PM
WE DO A FOLLOW UP CHEST X-RAY AFTER A THORACENTESIS TO CHECK FOR LUNG INFLATION AND TO BE SURE ALL FLUID IS GONE. THE CHEST XRAY CODE 71020 KEEPS GETTING DENIED. WE TRIED A 58 MODIFIER AND NOW A 25 STILL NOT GETTING PAID FOR THE CHEST XRAY. IS THERE A MODIFIER WE CAN USE? THANKS, VANNA DIAGNOSTIC ULTRASOUND CONSULTANTS vannap@drflinn.com
SuperCoder Answered Wed 06th of December, 2017 04:47:42 AM

Hi,

The immediate, initial chest x-ray after thoracentesis is bundled and should not be coded according to CMS. Just like the immediate, initial chest x-ray after central venous catheter placement. Others before or after for medically necessary reasons could be coded with -59. NCCI Policy Manual effective January 1, 2012 (though the edits are already in place).

For further reference consider the following:

https://www.supercoder.com/coding-newsletters/my-pulmonology-coding-alert/cci-edits-173-32422-71010-bundle-and-more-improve-your-pulmonary-coding-options-this-quarter-108569-article

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