Wiki Help with Segmentectomy

[harebt@charter.net]

Good Afternoon,

The physician shingled a rib to prevent uncontrolled breaking of the rib during a Segmentectomy (32484). Then once done with the procedure he repairs the rib. Can you bill seperately for the repair of the rib? Or is this considered part of the procedure? My understanding is shingled is a controlled break. Please advise. The physician says we should be able to bill 21811 for the repair of the rib.

Thanks for your help!
Tina

 

[fwnewbie]

You cannot bill to repair a what you broke to get access to the surgical site. So if it wasn't broke in the first place, you can't bill it.

ETA: IMO your physician's desire to recoup a fee for the work already included in the procedure is an indication of why coding/billing is so difficult.

 

[lmccannon]

The approach and/or repair of surgical site needed to gain access is inherent to the the procedure and not separately billable.

 

[harebt@charter.net]

Thank you both so much for your response.