• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

Help! Modifiers!

Hopp

Guru
Messages
228
Best answers
0
How do you know which code to apply the modifier EX: 59
A Right Hemicolectomy; along with small bowel resection?
Where do you find the answers? Thank you
 

007CPC

Guest
Messages
302
Best answers
0
I haven't done CPT in a while but I'll give it a shot

How do you know which code to apply the modifier EX: 59
A Right Hemicolectomy; along with small bowel resection?
Where do you find the answers? Thank you
My coding is book is outdated, but one of the two elements: the "hemicolectomy" along with "resection" are most likely considered bundled according to the CCI. And because of some certain circumstance, the physician feels it is necessary to report "one of the two elements(procedures)" as an exclusive service from each other, despite what the CCI says; do to the definition of modifier 59 in appendix A of CPT.

I hope this is clear, if not, I am sure another coder will explain the use more transparently this Monday.
 

ruhood

Guest
Messages
56
Best answers
0
Check to see if the procedures are bundled. If they are not, then I would list the procedure with the highest reimbursement first followed by the other procedure with the -59 modifier.
 
Top