Forum - Questions & Answers

Apr 28th, 2015 - vochrisq 3 

CPT® 46040 w/ 45990

I billed CPT® 46040 and 45990 w/ modifier 59. CPT® 45990 w/ 59 denied. Am i billing with incorrect modifier? Thanks!

Apr 28th, 2015 -

re: CPT® 46040 w/ 45990

This is the information I found, hope it helps:)

The surgeon did a rectal examination under anesthesia and on the same session also did the incision and drainage of perianal abscess.

How do I code and bill for this?

Look at 46050 for the I&D - 46050 Incision and drainage, perianal abscess, superficial. Global Days 10 days.

And for the rectal examination under anesthesia, you may look at 45990 Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic

But be careful as these 2 codes are not billable together. Because 45990 is a component of 46050.

Per CCI Edits V18.1 Effective April 1, 2012 - 46050 with 45990 on second column has an indicator "0".

Apr 28th, 2015 - petunia 195 

re: CPT® 46040 w/ 45990

45990 is bundled with 46040 with no modifier allowed. Only 46040 should be billed.



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