Wiki 52355, 52332, 52354-51, 52353-51

[klen]

My doc billed 52355, 52332, 52354-51 and 52353-51. Medicare denied 52332 and 52354-51 as "this procedure or procedure/modifier combination is not compatible with another procedure provided on the same day. I identified the CPT guideline which states not to report 52332 in conjunction with 52353, but I am unable to find any guideline which would indicate 52354-51 is bundled with another procedure and I believe the modifier is appropriate. Any help would be appreciated.

 

[sxcoder1]

52355 includes 52354 (a biopsy would be included with the resection), and instead of 52353 and 52332, you should have billed 52356 which is lithotripsy with stent.

 

[liqgold2@aol.com]

I would need the full operative report to best answer this question.