tci General Surgery Coding Alert - 2011 Issue 4

Reader Questions: 58 Modifier Marks Staged Surgery

Question: My surgeon does a vein transposition as a staged procedure after creating a direct anastomosis. Can I bill the transposition as a staged procedure?New Jersey SubscriberAnswer: Yes, you can bill the vein transposition (36819, Arteriovenous anastomosis, open; by upper arm basilic vein transposition) as a staged procedure following the direct anastomosis creation (36821, ...direct, any site [e.g., Cimino type], [separate     procedure]).That is, assuming that your surgeon did both procedures in full. Having a surgeon perform a direct anastomosis for more immediate access followed by a subsequent transposition would not be unusual.You...

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