Wiki 26121 and 26123

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apoland

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Hello,
I understand the difference between 26121 and 26123. I am questioning if my provider performs a partial palmar fasciectomy including pip joint (26123) on the pinky and then in a totally separate incision did fasciectomy of the palm only at the base of the index finger (26121), could we code each separately? Would separate incisions support a 59 modifier?

Thank you in advance!
Autumn
 
Not the incisions necessarily. You have one procedure being performed on the little finger, and treating that little finger is not going to treat the index finger. In other words, you have two separate procedures treating two separate anatomical structures. So yes, in this situation, a -59 or -XS modifier is supported.
 
Orthocoderpgu said:
Not the incisions necessarily. You have one procedure being performed on the little finger, and treating that little finger is not going to treat the index finger. In other words, you have two separate procedures treating two separate anatomical structures. So yes, in this situation, a -59 or -XS modifier is supported.
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Thank you for your reply. I guess I have a follow up question. If palmar fasciectomy of only the palm at the base of the little finger (26121) is performed along with palmar fasciectomy of only the palm at the base of the thumb, separate incisions, would this allow for billing 26121 twice? My understanding was 26121 applied to the entire palm whether multiple incisions at the base of different fingers, that's why it has a meu of 1. If that is correct, wouldn't the same logic apply to 26123, isn't that why there is only an add on for the additional finger pip flexor release? I may be over thinking, but I just want to be certain. Appreciate your help!
 
apoland said:
Thank you for your reply. I guess I have a follow up question. If palmar fasciectomy of only the palm at the base of the little finger (26121) is performed along with palmar fasciectomy of only the palm at the base of the thumb, separate incisions, would this allow for billing 26121 twice? My understanding was 26121 applied to the entire palm whether multiple incisions at the base of different fingers, that's why it has a meu of 1. If that is correct, wouldn't the same logic apply to 26123, isn't that why there is only an add on for the additional finger pip flexor release? I may be over thinking, but I just want to be certain. Appreciate your help!
Click to expand...
I'm looking at it this way. You know that multiple digits with both palmer and joint capsule releases are possible to report together on the same hand. That's code 26125. The reason for the MUE of one for code 26123 is because you have to use the add-on code for additional digits. But as you can see more than one digit is allowed even with a partial palmer release. 26121 and 26123 are not the same procedure. They are not being performed on the same digit. Would I bill 26121 more than once in a day? No, but the edit between 26121 and 26123 are for "Mutually Exclusive". Code 26123 is not a continuation of 26121 in this specific case. It's being performed on separate digits. So in this case I think you can make an argument that both codes are supported.
 
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I think that makes sense. I know I'm probably over thinking it. Truly appreciate your time. Thank you!
 
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