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Internal Medicine Coding Alert

You Be the Coder:

Choose Between -51 and -59 for Wound Sites

Published on Fri Aug 01, 2003 Print Friendly and PDF PDF

Question: Should we use modifier -51 or modifier  -59 to report multiple wound repairs on different sites?

Indiana Subscriber

Answer: To choose between modifiers -51 (Multiple procedures) and -59 (Distinct procedural service) for claims with multiple laceration repair codes, first determine if the National Correct Coding Initiative (NCCI) bundles the codes. 
 
If no NCCI bundle exits, use modifier -51. "When more than one classification of wounds is repaired," CPT directs you to use modifier -51. If the NCCI bundles the claimed codes, however, you should instead report modifier -59 to override the edit. Otherwise, the payer, if it follows the edits, will reject the component code as bundled into the more comprehensive code.

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