# understanding 20103



## ggparker14 (Nov 15, 2010)

I am new at coding and am confused about when you should use code 20103.  I have a physician that believes that she can use 26418 with 20103 in this following case. I would love to have other opinions.  The op note reads:  Under adequate general anesthesia a well-padded tourniquet was applied at the right upper extremity.  The right arm was prepped and draped in sterile fashion.  The right arm was elevated, exsanguinated, tourniquet inlated to 240 mmHg.  The incision was enlarged proximally and distally in Z-type fashion.  The cultures were taken.  The wound was thoroughly irrigated with antibiotic solution.  After the wound was irrigated clean goves, clean instruments and clean drapes were applied.  The extensor pollicis longus tendon was found to have a clean horizontal laceration in the zone II area. Subsequently repaired with the Winters-Gelberman suture technique utilizing two modified Kessler suture technique with 3-0 Tycron. The tension was adjusted and the sutures were tied. The edges of the tourniquet released. minimal hemostasis and the wound infiltrated with 0.50% plain Marcal. The skin was reapproximated with interrupted sutures of 4-0 nylon. Xeroform, a dry sterile bulky dressing was applied and the patient was placed in a thumb spica splint with the wrist in some extension and the thumb in extension. The patient tolerated this well. No complications.


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## FTessaBartels (Nov 17, 2010)

*Separate Procedure*

The 20100-20103 codes are defined in CPT as *separate procedure*.

This means that you can only code them when NO more extensive procedure was performed. 

In the operative report you gave as an example, there is only one wound being addressed. The definitive repair 26418 includes the exploration of the traumatic wound.

By the way, you should note that CCI frequently does NOT include separate procedures in the bundling edits - because by defninition a *separate procedure *is coded ONLY when it is a stand alone (i.e. separate) procedure. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## ggparker14 (Nov 17, 2010)

Thank you for your help.


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