louise Posted Thu 28th of March, 2019 14:58:02 PM
PLease advise on coding: 69710 69799 cartilage and scar were resected to achieve a flat soft tissue plane. Inferiorly the skin was elevated along the parotideomasseteric fascia. Posteriorly the skin flap was elevated using a combination of tenotomy scissors, the 15 blade, and bovie electrocautery. The skin flap was elevated passed the methylene blue dye. The skin was thinned using bovie electrocautery and a 15 blade. A freer was used to elevate soft tissue off the periosteum. The cochlear system was used to place the 3 vistafix implants. A 5mm skin punch was used to remove the overlying skin for placement of the abutments. Excess skin was closed using 5-0 FAST around the abutments. The 5mm skin punch was used to go through the scalp for the BAHA. A vertical incision was made through the scalp due to the thickness and the scalp was thinned using a 15 blade. Using the cochlear system the BAHA abutment was placed. 3-0 vicryl sutures were used for closure of the soft tissue, followed by 5-0 FAST
SuperCoder Answered Fri 29th of March, 2019 09:38:47 AM
As per the above mentioned documentation, appropriate code will be 69710 only. According to clinical responsibility of code 69710, the provider creates a postauricular incision overlying the temporal bone. He dissects any tissue to access the outer skull cortex, where he drills a circular depression into the bone behind the mastoid cavity. He places the internal coil in the depression and secures it to the skull using titanium screws. If needed, he thins the subcutaneous tissue overlying the coil. The provider irrigates the area, sutures the incision closed, and applies a dressing. If operative report documentation justify that physician had work greater than that usually required for the listed procedure than you can add modifier 22(Unusual procedural services) with CPT 69710. Also attach the copy of operative along with the bill to avoid deduction in payment.
louise Posted Fri 29th of March, 2019 10:54:19 AM
Thanks so the adjacent tissue transfer is inclusive with 69710?
SuperCoder Answered Mon 01st of April, 2019 04:45:35 AM
Generally adjecent tissue transfer procedure not performed with 69710, and if performed then append modifier 22 with 69710.