# Nuss procedure



## pjhollin (Jul 28, 2015)

My surgeon sometimes puts two bars in when doing a nuss procedure.  He is using the same incision but thinks he should be able to bill CPT 21743 x 2.   I would agree with him if he were making two seperate incisions.  He is making an incision on both sides of the chest but he would do that when inserting one bar.  Also, when he removes two bars he feels he is justified in billing CPT 20680 x2.  The stabilizer for one bar is on the right and the stabilizer for the 2nd bar is on the left. 

Thank you for any advice you can give.


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## mkmgt001 (Dec 6, 2018)

*CPT 21743 x 2 units*

I have essentially the same question as above...if two bars are inserted during the NUSS procedure, does this warrant billing 21743 twice? The Encoder360 Lay Description of this code indicates that "Usually only one bar is placed.".  It also indicates to report modifier 22 "If significant additional time and effort are documented". Based on this information, I'm thinking this code should only be reported ONCE regardless of 1 or 2 bars being inserted...and as noted, modifier 22 might be appropriate IF significant additional time & effort are documented. I should also note that the surgeon is only making ONE incision on the right side & on the left side - NOT an incision for each bar, which seems to further support only reporting this code with ONE unit. Any thoughts or comments??

Thank you.


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