Question 45385,45380,45381 modifiers

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Hello,
I have codes 45385, 45380, and 45381.
I’m adding modifiers 33 and 59, but wouldn’t I add 51 as well?

45385-33
45381- 33, 51,59
and 45380- 33, 51,59
My boss says not to add 51 because that’s to be added to example a flip (egd/colon or egd/flex)
 

madone3

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Good afternoon,
Just curious to know the outcome on this claim. We billed these codes as well, 45385 (33), 45380 (59) (33), and 45381 (33), with no 59 modifier. CCI edits say a 59 modifier is not needed on 45381, but the insurance company is denying it as included in the payment for the primary procedure. Is it ok to bill 45381 with a (59) modifier even though CCI edits say otherwise? Please let me know. Thank you so much for your time
 
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