Diane Posted Wed 06th of February, 2019 11:35:02 AM
What would the CPT code be for excision of calcific tendonitis deposit from the attachment medial femoral condyle of the medial collateral ligament? And, Excision of exostosis medial femoral condyle? I am looking at 27355 for the exostosis of MFC but not sure about the calcific tendonitis deposits.
SuperCoder Answered Thu 07th of February, 2019 05:04:31 AM
CPT 27355 seems appropriate for the excision of benign tumor of femoral condyle. Whereas, the location of both the procedures is same, then it would be considered part of the main procedure i.e. 27355, especially if the surgeon did not perform the second procedure with a separate incision. However, there is no specific code for excision of calcified tendonitis of femoral condyle, hence CPT 27899 (Unlisted procedure) can be used for this procedure. It is suggested to append modifier 22 (Increased procedural services) with CPT 27355, in case physician put extra efforts on procedure.
In order to append modifier 22 to a surgical procedure, check that the physician documented the reason(s) why the work he performed was more than he typically performs, and the documentation should include any or all of the following:
- Increased intensity
- Additional time
- Technical difficulty
- Severe patient condition, which causes the surgery to be difficult, dangerous to the patient, and requires additional physical and mental effort from the physician
An unusual procedure is not when the physician took only a few extra minutes on the patient’s case or when the physician documents that the procedure was only slightly more difficult. There is an average range of difficulty for every procedure. A procedure could be slightly more difficult and still meet the definition of the procedure and not warrant appending modifier 22.
Hope this helps!