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CCI edit question ENT

Michelle Posted Wed 08th of February, 2012 18:59:36 PM

When is modifier 59 appropriate when billing 69440 and 69660 together?

SuperCoder Answered Mon 13th of February, 2012 20:11:02 PM

When the incision is on the other ear.

Otherwise, when your otolaryngologist performs middle-ear exploration (69440, Middle-ear exploration through postauricular or ear canal incision) that results in a procedure, you should charge for the operation, not the middle-ear exploration. That’s because middle-ear exploration is a separate procedure in which the otolaryngologist performs no major treatment. When the surgeon performs a surgical procedure, such as stapedectomy(69660), the middle-ear exploration (69440) becomes a component of the primary service (69660).

Jen Godreau, CPC, CPMA, CPEDC

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