Wiki Looking for some feedback on 64721 + 26145

[Barbs63]

Hello Everyone,

I am struggling with what should be very simple. I am looking for any advice on how to code the following. When is it appropriate to bill 26145 & 64721 together and when it isn't.

Here is a brief example - Ctr is standard
Here is the part of the surgery I need your opinions on:
the flexor tendons had a thickened hypertrophic tenosynovium- tenolysis x 4 with pickups and temotomies. hemostasis and clsure performed.
**dx M65.4, m19.041 & G56.01 - all done in the same incision

I have one coder saying 64721 + 26145 x4 and another just 64721 and one saying add a 22 to 64721 in certain cases

Is there anything cut and dry with this
My physician says 64721 + 26145 x4 do you all agree? if not, why?
Thank you SO much for any advice

 

[AmandaM.318414]

Looking for some feedback on 64721 + 26145

Hi,

Sometimes I want to pull out my hair over wrist and hand coding. Hand cases don't get many takers.
That being said, I see a wrist code 64721, and a hand/finger code 26145 with separate distinct pathology (dx). I would code 64721 and 26145 x 4 if very well supported by the report. Since they are the same incision, if his documentation is weak and doesn't really support the full description of 26145, then I might suggest the modifier 22 as your 2nd choice. Ask the physician directly to explain his work, that is what I do.

Hope this helps you some.

Best Regards,