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E. maria Posted Thu 11th of June, 2015 18:15:00 PM

An I&D or perirectal abscess was done on day #1. The following day the patient was taken back to surgery for another I&D with debridement. Day #3 patient underwent a diverting colostomy and irrigation and drainage of perirectal wound.

Can I code CPT 46040 for day 2, & 3? If so, do I use modifier 58? Patient with perirectal abscess and paraplegia

SuperCoder Answered Fri 12th of June, 2015 05:22:53 AM

Well, CPT 46040 fits for the 2nd day procedure. According the global period of the 46040, next day drainage of the wound will not be charged. So for 3rd day diverting colostomy will be coded.

E. maria Posted Fri 12th of June, 2015 12:18:46 PM

What I need to know is if I should append modifier 58 to the second 46040 and to the colostomy code.

SuperCoder Answered Mon 15th of June, 2015 04:09:04 AM

Well, if on second day the site of the procedure for CPT 46040 was same, then 58 will not go with it. And if the site of the procedure was different, then procedure can be billed without the modifier 58. And it seems that diverting colostomy is a new procedure so need not to append modifier 58 with the procedure. Hope it help!

E. maria Posted Mon 15th of June, 2015 15:16:41 PM

CPT code 46040 has a 90 day global, so I need a modifier to bill for the repeat procedure done the following day. I guess I'm not explaining correctly?

SuperCoder Answered Tue 16th of June, 2015 03:12:13 AM

Ok. For second day procedure there can be two situations with the procedure performed, it can be planned/ staged/ related procedure or unplanned return (due to unanticipated clinical condition) to operation theatre. If it is planned staged procedure for the already performed I&D then use modifier 58, and if it is unplanned returned to operating room due to unanticipated clinical condition then use modifier 78. Hope it helps!

E. maria Posted Tue 16th of June, 2015 14:09:59 PM

Thank you!

SuperCoder Answered Wed 17th of June, 2015 01:30:33 AM

Happy to help!

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