Wiki 25605 with 76000

[zaida120]

Auditing charges in our ortho department and am stumped.
One of our managers coded 25605 with 76000 modifier 26. I though that 25605 included procedure 76000 so my thought was this is incorrect and only 25605 should be billed. Our PMS has code correct and when I performed the code check on this it stated that 25605 can be used if a modifier 59 is used.

My question is why code for it if it is already included in the primary procedure code?

Any thoughts would be greatly appreciated!

 

[mbort]

You are right--it is considered part of 25605. The 76000 bundles with the 25605. By adding the 59 modifier she is unbundling. (unless of course the fluoro is on a different body part other than the fracture)

 

[zaida120]

It is the same body part. Thank you for your quick reply!