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Cyberknife repeat on multiple lesions

Caralee Posted Mon 25th of June, 2012 15:18:50 PM

There was a previous post on a cyberknife procedure for 3 days in a row, the modifier suggested was 79. Shouldn't a modifier 58 be used since this is a there are multiple lesions it seems to be a related and staged procedure. The patient I have had cyberknife on multiple lesions back in Feb and has recently undergone radiosurgery on the metastatic lesions again. Wouldn't the modifier be 78 on the first since it is still in the postop period from Feb and 58 on the add'l.

SuperCoder Answered Tue 26th of June, 2012 06:43:09 AM

There is insufficient information provided to allow for accurate coding. First, we need to know which lesions were removed - cranial lesion, prostate lesion etc. If it's cranial lesion, even though there were multiple sessions (days), there is a limit of reporting treatment of five lesions altogether. Since metastases are typically simple lesions (although the location may warrant choice of a complex code), the first lesion would be reported with 61796 and up to four additional lesions would be reported with the add-on code 61797.

Caralee Posted Fri 20th of July, 2012 18:29:12 PM

Patient had metastatic breast cancer to the brain, first lesion was done on 5/9/12 then another on 5/10/12...5/11/12...5/15. Would the cpt code still be 61796 for each followed by a modifier?

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