# emergency chicothyroidotomy followed by conversion to trachostomy



## Robin R (Jan 8, 2010)

Good Afternoon!

I have a sort of complicated scenerio that I was hoping someone may be able to help me with. I code for the physician services.

I have an OP report with the following situation:

Patient had a total thyroidectomy earlier in the day by a different physician in a different division so the 78 modifier would not be appropriate.

The patient is now returning because they developed a hematoma at the surgical site & my physician is performing an incision and drainage of the hematoma (CPT 10140).

After coming out of the anesthesia, as they were about to take the patient to the recovery room, the patient coded & my surgeon performed an emergent surgical cricothyroidotomy (CPT 31605).

The patient was then taken back to the OR where my surgeon converted the cricothyroidotomy to a tracheostomy (CPT 31600).

31605 and 31600 are CCI edits and cannot be billed together.  I am thinking of coding as:

31600-22
10140-51

Does this seem right?  Any other suggestions?

Thanks in advance for your help!


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