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You Could Be Losing $368 in Reimbursement to Your Cyst Excision Claims Unless You Know This

Posted on 05. Apr, 2012 by in Hot Coding Topics

Unless you know neck and ear anatomy really well, you could be leaving dollars on the table. If your ENT performs a facial tissue transfer (14040) and you report branchial cleft cyst excision (42810) instead, you’ll lose 10.82 relative value units—which is $368 of lost revenue.

See if your ENT vocabulary is up to par by examining the following operative report.

Code This Excision

Procedure: Excision of left preauricular first branchial cleft sinus tract in a previously operated field.

Pre-/postoperative diagnosis(es): Recurrent left preauricular first branchial cleft sinus tract.

Note: This procedure qualifies for modifier 22 because it is a revision surgery in a previously operated field.

Specimens sent to lab: Overlying skin plus the deep sinus tract.

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