Wiki 69436 vs 69610?

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Citra, Florida
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I have a case where it stated the patient received a Myringoplasty patch repair but then tubes were placed bilaterally. Based on CCI edits I cannot code for both so would I only code the tubes placed or the patch repair? But then the patch repair was only done on one side so I couldn't capture tube placement? Or would I be able to use a 59 modifier to override the relationship issue? o_O
 
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