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CAN I CODE A COMPLEX REPAIR & A GRAFT REPAIR TOGETHER FOR THE SAME SITE ?

Donna Posted Thu 20th of October, 2011 14:39:44 PM

Can I bill a complex repair & a graft together for the same site on the same date of service?

SuperCoder Answered Thu 20th of October, 2011 17:40:28 PM

Adjacent Tissue Transfer (CPT 14041) excludes "closure of wounds using adjacent tissue without additional incisions (13100-13160)".
So, we can bill both together using modifier 59 with CPT 13132.

Donna Posted Fri 21st of October, 2011 12:03:19 PM

Thank you, Sonjit, for your response to my question about coding 13132 & 14041 on same day. I just want to make sure, however, that it can be billed for the "same site". I know I can bill it for a different site using modifier 59 but just wasn't sure about doing both for the same site. Do I understand that your answer indicates that it is ok for the "same site"?. Thanks

SuperCoder Answered Fri 21st of October, 2011 15:32:17 PM

If on same site, we can NOT report complex repair along with ATT, but if at a different anatomical site we can report with modifier 59.

GUIDELINES:
Frequently adjacent tissue transfer or tissue rearrangement is employed (Z-plasty, Wplasty, flaps, etc.). This family of codes, (CPT codes 14000-14350), involves excision with adjacent tissue transfer and correlates to excision codes. Excision CPT codes (11400-11646)and repair CPT codes (12001 – 13160) are not to be separately
reported when CPT codes 14000-14350 are reported.

REF:
http://www.iwcc.il.gov/chap3final.pdf

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