ollielooya
True Blue
Not sure at this point which forum to use to post this question, so I'll start here in the General Forum:
RE: the NCCI edits and the use of modifier 59, what exactly is meant by the phrase "different anatomic sites...?"
EXAMPLE: doctor performs a major joint injection 20610 in the right shoulder glenohumeral joint, and then a right shoulder suprascapular nerve block for her advanced osteoarthrosis and arthropathy.
NCCI edits bundles the suprascapular nerve block. Modifier 59 will remove the edit, and since the suprascapular block was not used as anesthesia for the major joint injection, would this fit the criteria to allow for it's use?
Basically, just trying to understand if the suprascapular and glenohumeral are considered the "same" or "different" anatomic site of the R. shoulder? Surely, there must be an easy answer to this, but so far I'm receiving different answers from other coders, and unfortunately I'm still on the "fence" although leaning more towards the conservative approach. Where can I find a more authoritative source for help? If my coding colleagues have different opinions on this, how would this hold up in an audit? Basically at the mercy of who does the audit, right?
RE: the NCCI edits and the use of modifier 59, what exactly is meant by the phrase "different anatomic sites...?"
EXAMPLE: doctor performs a major joint injection 20610 in the right shoulder glenohumeral joint, and then a right shoulder suprascapular nerve block for her advanced osteoarthrosis and arthropathy.
NCCI edits bundles the suprascapular nerve block. Modifier 59 will remove the edit, and since the suprascapular block was not used as anesthesia for the major joint injection, would this fit the criteria to allow for it's use?
Basically, just trying to understand if the suprascapular and glenohumeral are considered the "same" or "different" anatomic site of the R. shoulder? Surely, there must be an easy answer to this, but so far I'm receiving different answers from other coders, and unfortunately I'm still on the "fence" although leaning more towards the conservative approach. Where can I find a more authoritative source for help? If my coding colleagues have different opinions on this, how would this hold up in an audit? Basically at the mercy of who does the audit, right?