ljones88
Networker
Hi all,
I'm trying to get clarification with 36589 and 12001. NCCI bundles the two codes. If I understand it correctly, the only reason m59 would support is if the physician is doing a simple repair separate from the entire cath removal (like deep laceration to the head or something).
My doctor is under the impression that 36589, and 12001/59 is billable based on his documentation (citing separate incisions) but I believe the repair is included in the removal (since you have to obviously close the wound)... Op report reads:
Informed consent was obtained. The patient was brought to the operating room and placed in a supine position with the head of the bed approximately 15 degrees elevated. The location of the catheter was inspected and the location of the cuff identified. The existing dressings were removed. The area was then prepped and draped in the usual aseptic fashion. Local anesthesia was administered at the entry point of the catheter in the skin and over the area of the palpable cuff. Blunt and sharp dissection were then used to dissect the tissues along the catheter while traction was applied to the catheter. The cuff was then reached and dissected. Once free the catheter was withdrawn with the patient in Trendelenburg while pressure was maintained along the tract to obtain hemostasis. The catheter tip and cuff were inspected and found to be intact. The catheter was discarded. A pursestring suture of 3-0 Monocryl was applied around the deep tissue in the tunnel. The suture was secured to achieve hemostasis at the tunnel tract extending centrally. An ellipse of skin approximately 2 cm wide was excised around the catheter entry site and dissection was carried through the subcutaneous tissue with electrocautery. The scar tissue was resected and sent to pathology. The subcutaneous tissue of the incision was reapproximated with 3-0 Monocryl subcutaneous closure and the skin was reapproximated with 3-0 Monocryl subcuticular closure. The wound was cleaned and Steri-Strips were applied. pressure dressing was applied.The patient was transferred to the recovery room in stable condition.A The patient tolerated the procedure well
I'm trying to get clarification with 36589 and 12001. NCCI bundles the two codes. If I understand it correctly, the only reason m59 would support is if the physician is doing a simple repair separate from the entire cath removal (like deep laceration to the head or something).
My doctor is under the impression that 36589, and 12001/59 is billable based on his documentation (citing separate incisions) but I believe the repair is included in the removal (since you have to obviously close the wound)... Op report reads:
Informed consent was obtained. The patient was brought to the operating room and placed in a supine position with the head of the bed approximately 15 degrees elevated. The location of the catheter was inspected and the location of the cuff identified. The existing dressings were removed. The area was then prepped and draped in the usual aseptic fashion. Local anesthesia was administered at the entry point of the catheter in the skin and over the area of the palpable cuff. Blunt and sharp dissection were then used to dissect the tissues along the catheter while traction was applied to the catheter. The cuff was then reached and dissected. Once free the catheter was withdrawn with the patient in Trendelenburg while pressure was maintained along the tract to obtain hemostasis. The catheter tip and cuff were inspected and found to be intact. The catheter was discarded. A pursestring suture of 3-0 Monocryl was applied around the deep tissue in the tunnel. The suture was secured to achieve hemostasis at the tunnel tract extending centrally. An ellipse of skin approximately 2 cm wide was excised around the catheter entry site and dissection was carried through the subcutaneous tissue with electrocautery. The scar tissue was resected and sent to pathology. The subcutaneous tissue of the incision was reapproximated with 3-0 Monocryl subcutaneous closure and the skin was reapproximated with 3-0 Monocryl subcuticular closure. The wound was cleaned and Steri-Strips were applied. pressure dressing was applied.The patient was transferred to the recovery room in stable condition.A The patient tolerated the procedure well