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Vasectomy - unilateral

David Posted Fri 01st of April, 2016 16:28:05 PM

We had a patient come in for a bilateral vasectomy. The right side was done and then when the doctor went to do the left he was unable to get to the left and it was determined the patient had a hydrocele on the left. So he only had it done on the right during the first visit. We billed 55250 since this can be unilateral or bilateral.

However with the hydrocele now resolved on the left the patient is now back in to have the left side we will again be billing the 55250....would the we bill with the 58 modifier since we did know he would be coming back to have the left done....or a 76 for repeat by the same provider?

or is there a different way these need to be billed?

Thank you

SuperCoder Answered Mon 04th of April, 2016 03:13:59 AM

Hi Kelly,
I guess we can bill 55250 without any modifier. Neither it comes in global day nor will it be a repeat procedure. Since vasectomy procedure was carried on right side, but next time patient comes in for left side vasectomy, so it will not be considered as repeat procedure.

David Posted Mon 04th of April, 2016 13:52:17 PM

Actually 55250 has a 90 days global and the other side was done with in the 90 then would the 58 modifier be appropriate?

SuperCoder Answered Tue 05th of April, 2016 04:07:14 AM

You are correct. Since we did know he would be coming back to have the left vasectomy done and was carried within the global day, we will use modifier 58 with 55250. Thank you.

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