Forum - Questions & Answers

Aug 12th, 2018 - LBAROGIANIS 250 

CPT 61510 and 61518- multiple tumors

Does anyone know how many tumors are included in these codes? My coder appended modifier 22 for the additional tumors. I am wondering if it's worth it to appeal. Please advise,

Sep 17th, 2018 - ChrisW   256  1 

re: CPT 61510 AND 61518- MULTIPLE TUMORS

Since only one craniectomy was performed, you can only report it once. Chose the code that best describes the procedure and the location. Using Modifier 22 does not mean there were multiple tumors removed, only that work required was substantially greater than typically required. The documentation should reflect the work and time spent on the extra tumors to indicate the detail of the complexity, but you cannot bill additional procedures.

22-Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code

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