Wiki 21556 & 13132

nlbarnes

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Hello - if appropriate, which X modifier would you use or would you use 59? Or, would 13132 only be allowed if it's a different site?

Procedure note:
This was noted to be a multilobulated lipoma deep to the subcutaneous tissue and extending to the deep muscles of the cervical spine measuring 3.5 cm Subsequently using sharp and blunt dissection, the mass was exposed. and in a circumferential and systematic manner soft tissue attachments to the lesion were dissected free. The mass was sent to pathology for permanent section. The neck was subsequently irrigated and suctioned clear. Unfortunately, the skin would not close primarily without tension as such complex closure was required. The wound incision measured 3.5 cm. Using Bovie cautery, the wound was widely undermined in the subcutaneous plane, superior, laterally and inferiorly, allowing mobilization of the skin edges. This afforded no tension on the wound edges. The muscle was re-approximated with running buried 3-0 Vicryl suture. The sub-dermis was closed with 4-0 vicryl suture in an interrupted buried fashion.
The skin was closed with 4-0 Monocryl in a running locking fashion. . The neck was cleaned. Antibiotic ointment was applied as a dressing.
 
Those 2 codes are bundled so I would not bill the complex closure for the same site.
Hello - thank you for your reply. The reason that I was allowing 13132 is because it's for a complex closure. 21556 states simple and intermediate closures are included in the procedure and that complex closure is separately payable.
 
This is the Medicare NCCI policy:
Closure/repair of a surgical incision is included in the global surgical package. Wound
repair CPT codes 12001-13153 shall not be reported separately to describe closure of
surgical incisions for procedures with global surgery indicators of 000, 010, 090,

So I would say for Medicare do not bill, but other insurances you may be able to get it paid.
 
This is the Medicare NCCI policy:
Closure/repair of a surgical incision is included in the global surgical package. Wound
repair CPT codes 12001-13153 shall not be reported separately to describe closure of
surgical incisions for procedures with global surgery indicators of 000, 010, 090,

So I would say for Medicare do not bill, but other insurances you may be able to get it paid.
Thanks so much!
 
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