AHA Coding Clinic® for HCPCS - 2017 Issue 2; Ask the Editor

Carpometacarpal arthroplasty

Patient with right thumb metacarpophalangeal (MCP) joint instability, carpometacarpal (CMC) osteoarthritis, and wrist scaphotrapeziotrapezoidal (STT) arthritis presents for treatment of the thumb and wrist. A CMC arthroplasty was performed along with excision of the trapezoid bone. Arthrodesis was also performed on the MCP joint using K-wires to immobilize the joint. Fluoroscopic images showed the hardware utilized was placed appropriately. If a patient has a thumb CMC arthroplasty, MCP joint arthrodesis and excision of the trapezoid bone, for wrist STT arthritis and not for the CMC osteoarthritis, can excision of the trapezoid bone be separately reported? An NCCI edit is produced when these procedures are reported separately. Therefore, can modifier 59 be appended based on the procedures and the diagnosis codes? ...

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