Ask Dr. Z

Would you bill both 21615 and 21700 for this? Can both be billed through the same incision, or must it be separate incisions? It feels like you would have to divide the muscle to remove the rib so it should be inherent. However there are no bundling edits, and I can't find anything saying you can not bill both. "We began by making a supraclavicular incision...We then divided the anterior scalene muscle...We continued our dissection down the anterior scalene muscles to where it inserted on the 1st rib...Then an elevator was used to elevate the periosteum and expose the rib from the clavicle all the way to the cervical vertebrae. We then used a small oscillating saw to divide the rib in 2 places. This small piece of rib was passed off and then we used the rongeur to continue our dissection anteriorly and posteriorly. We used bipolar cautery whenever we were cauterizing the anterior scalene muscle. We did have to divide part of the middle scalene muscle...We reapproximated the sternocleidomastoid...We then closed the platysma in a running fashion."