Medical Billing Forum
Coding => Coding => : jwangelin November 16, 2010, 10:39:35 AM
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I work for an Ob-Gyn physician. She performs ablations and at the same time does a D&C. Can I bill 58563 along with 58120 and mod 51, or is 58120 considered part of 58563?
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How are they doing the ablation are they using Novasure?
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Yes
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CPT/HCPCS to CCI Code Check
NOTE: Effective 1/1/09, the facility version of NCCI edits will include edits for the following categories of service: Anesthesia (00100-01999), E&M (92002-92014, 99201-99499), and MH (90804-90911). Prior to 2009, these code pairs were excluded from the facility edits.
Code / Description
58563 HYSTEROSCOPY, ABLATION M Rel Wt: 37.22
No bundling issues exist
58120 DILATION AND CURETTAGE M Rel Wt: 20.05
Code 58120 is a component of Column 1 code 58563 but a modifier is allowed in order to differentiate between the services provided.
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So is 51 the appropriate mod, or is 59.
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Had the D&C been performed for diagnostic purposes for a clearly separate indication, you could report 58120 separately with modifier 59 (distinct procedural services) appended to override the CCI edit otherwise the 58563 would cover it all