Forum - Questions & Answers

Jan 29th, 2018 - alleegator13

gangilon cysts

Can you use 20612 with 10160 procedure codes? This is also a new patient.

Feb 7th, 2018 - ChrisW   256  1 

re: gangilon cysts

New patient E/M code should be paid (there are no edits with a NEW patient and the following codes) (do not bill the E/M with a 25 modifier, 'new patient' codes and are automatically excluded from the global surgery package, meaning that they are reimbursed separately from surgical procedures).

When billing 20612 and 10160 procedures together there is a column 2 edit. and only 20612 will be paid.
20612 - Aspiration and/or injection of ganglion cyst(s) any location
10160 - Puncture aspiration of abscess, hematoma, bulla, or cyst

Unless these are two distinct procedures or different anatomical sites both codes will not be paid, in other words, they cannot be billed together without a modifier 59, 51, LT or RT.

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