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Cord lipoma clarification

E. maria Posted Tue 15th of September, 2015 13:30:40 PM

Can you tell me when is it appropriate to charge for excision of a cord lipoma during repair of an inguinal hernia? CPT code 55520 bundles with CPT code 49505 and requires a modifier in order to be able to bill. Will it be unbundling if it is done on the same side as the inguinal hernia repair?

Thank you

SuperCoder Answered Wed 16th of September, 2015 07:03:03 AM

Well, it is not bundled with CPT 49505, however there is CCI edits relationship between both. So, use modifier 59 with CPT 55520 for proper billing. Whereas, both the procedure can be billed when performed on separate DOS. Hope it helps!

E. maria Posted Wed 16th of September, 2015 19:15:40 PM

I know there is no issue if billed on a separate DOS, I'm talking on the same date of service at the same same time as the hernia repair through the same incision. Is it ok to bill in addition to the hernia with modifier 59 since it is at a different organ?

SuperCoder Answered Thu 17th of September, 2015 03:57:12 AM

Yes, as there is CCI relationship between both the procedures, so it can be billed with modifier 59. CPT-49505, CPT- 55520-59. Hope it helps!

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