Wiki separate procedure confusion

[solocoder]

27605 (percutaneous Achilles tenotomy) is designated "separate procedure", but because it is a percutaneous procedure, wouldn't it ALWAYS be performed by separate incision/s?
Wondering if I can bill it along with a forefoot amputation.

Any thoughts?

 

[danskangel313]

For 27605:
"Because the code definition indicates this is a separate procedure, you should report the service only when not integral to the performance of a larger procedure that takes place at the same time.

These separate procedures by definition are usually a component of a more complex service and are not identified separately. They may be reported when performed alone or with other unrelated procedures or services. If performed alone, list the code; if performed with other unrelated procedures or services, list the code and append modifier 59, Distinct procedural service."

"Separate procedure" doesn't only discuss separate incisions, it also includes related anatomical sites. A procedure on the Achilles tendon and an amputation of the forefoot, although near each other, are not related anatomical sites, so the codes shouldn't bundle. I'd still check for edits though, just in case.

 

[solocoder]

Thanks, danskangel313. I have to admit, I've never been quite sure of the exact definition of different/same "anatomical site". So... same foot would not be considered same anatomical site?

 

[danskangel313]

Thanks, danskangel313. I have to admit, I've never been quite sure of the exact definition of different/same "anatomical site". So... same foot would not be considered same anatomical site?

It depends on what procedures are being done basically. But in your case, you have a procedure on the foot and another on a leg muscle, which just happens to be located near that foot.