Otolaryngology Coding Alert

Modifier 22 may be an option for complex work.Deciphering which excisions are payable together -- and which ones aren't -- isn't always a piece of cake. Scenario: An otolaryngologist performs 38724 (Cervical lymphadenectomy [modified radical neck dissection]) and the lymph node invades the deep musculature of the neck. Would you code this as:• 38724, or• 38724, 21556-51 (Excision, tumor, soft tissue of neck or anterior thorax, subfascial [e.g., intramuscular]; less than 5 cm, Multiple procedures)?Stick With a Straight LymphadenectomyIn the above scenario, 38724 alone would be the correct choice, advises Cheryl Starner, CPC, revenue integrity analyst at Truman Medical Centers in Kansas City, Missouri.Adding 21556 to a neck dissection code does not seem valid, says Wayne Koch, MD, professor of otolaryngology,head and neck surgery, and oncology and director of the head and neck cancer division of the department of otolaryngology at Johns Hopkins in Baltimore. The lymph node excision is already [...]