CCI Changes Billing for Bilateral,Modified RND
Answer: Thanks to the most recent version (9.0) of the national Correct Coding Initiative (CCI), you may now bill Medicare for both the partial glossectomy (41135, Glossectomy; partial, with unilateral radical neck dissection) and the second radical neck dissection (38720, Cervical lymphadenectomy [complete]). The glossectomy includes the first (unilateral) RND. To indicate that the second RND occurs at a different site from the unilateral RND, append modifier -59 (Distinct procedural service) to 38720. In addition, when the otolaryngologist performs a modified RND, you should bill 38724-59 (Cervical lymphadenectomy [modified radical neck dissection]) instead of 38720.
CCI changed the modifier indicator for 41135, 41145 ( complete or total, with or without tracheostomy, with unilateral radical neck dissection) and 42426 (Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection) from "0" to "1," which means that under certain circumstance you can use modifier -59 to bypass the edits. Codes 41135, 41140 ( complete or total, with or without tracheostomy, without radical neck dissection) and 41150 ( composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection) also now contain a "1" for the modified RND code (38724).
The changes, effective Jan. 1, mean you can bill for the second RND (38720) when performed with a
partial glossectomy (41135)
complete glossectomy (41145)
total parotid excision (42426).
The procedures include unilateral RND only. Append modifier -59 to the second RND.
In addition, you can report a modified RND (38724) with a
laryngectomy (31360, Laryngectomy; total, without radical neck dissection)
partial glossectomy (41135)
complete glossectomy (41140)
composite procedure (41150).
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