tci General Surgery Coding Alert - 2003 Issue 9

Coding Case Study: Amputation Following Bypass Is a 'Staged' Procedure

The Procedure: A 46-year-old male undergoes bypass graft (35661) for artherosclerotic cardiovascular disease (ASCD). Several weeks later, the patient must have an above-the-knee amputation with gangrene. A different surgeon in the same practice performed the amputation.The Challenge: A California reader wants to know: "Is the amputation related or unrelated to the bypass? In other words, should I append modifier -78 or -79 to the second procedure code?" The Solution: In this case, the first surgeon probably planned to proceed with the amputation if the bypass graft did not work. Further, the amputation in this case is not...

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