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Correct Coding Tissue Expander

Gary Posted Fri 02nd of December, 2011 20:40:12 PM

When a patient has two separate sites requiring insertion of a tissue expander, can '11960' be reported twice? I was told that perhaps modifier 59 could be used?


SuperCoder Answered Sat 03rd of December, 2011 03:32:02 AM

It can’t be reported twice because 150% bilateral payment adjustment (payment for two sides (50 or RT/LT) doesn't apply for this code 11960. Still if it is in two sides, again, it descriptor says it can include subsequent expansion during post-op visit, so I don't think it can be billed twice with -59.

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