Part B Insider (Multispecialty) Coding Alert

Published on Thu May 03, 2007 PDF

Warning: You should only use modifier 59 to report nail debridement code CPT 11720 and lesion paring/cutting codes CPT 11055-11057 if the nails were on a separate anatomical area than the lesions or in a different visit, according to MLN Matters Article SE0715.

Similarly, you can use the 59 modifier for nail trimming CPT 11719 and nail debridement code 11720 only if the procedures affect different nails or happen in different encounters, the Centers for Medicare & Medicaid Services (CMS) says. The same goes for lesion destruction code 17000 and lesion biopsy code 11100.

Editor's Note: See next week's PBI for more about the 59 modifier.