Part B Insider (Multispecialty) Coding Alert

Question: Can we bill CPT code 31600 with codes 38724, 41120, and 42890, or are these considered bundled procedures? 

Answer: According to the latest edition of Correct Coding Initiative (CCI) edits, you can bill all of these codes together. The claim would include: 

• 31600 (Tracheostomy, planned [separate procedure]) 
• 38724 (Cervical lymphadenectomy [modified radical neck dissection])  
• 41120 (Glossectomy; less than one-half tongue) 
• 42890 (Limited pharyngectomy).   

None of these procedures are bundled under CCI edits, but the tracheostomy is a separate procedure. That means the tracheostomy is considered inclusive whenever the surgeon performs any other procedure in the trachea during the same operative session. 

In your situation, everything can be coded separately because even though the physician completed other procedures on the neck (such as the modified neck dissection), you report both because it’s not part of the trachea section of the CPT® manual. If the payer denies 31600 because it is a separate procedure, appeal the denial by indicating that the separate procedure concept does not apply with the other three services performed. If you find that the tracheostomy is denied often from particular payers, it is recommended to add a modifier 59 (Distinct procedural service) with 31600 to indicate that the tracheostomy is not performed in the same site as the other procedures.