Wiki Mod - 50: please help settle a disagreement

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MnTwins29

MnTwins29

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A physician has been sending superbills for thyroid biopsies with modifier -50 because he has taken samples from both the left and right side. I say that this cannot have modifier -50 because the thyroid is not a paired organ - there is only one thyroid gland. Who, if either of us, is correct?
 
Modifier 51 instead of 59 in this instance.

I believe modifier -51 is better that -59 in this instance since the procedure is done on the 'same session , same provider' and same approach. Modifier -59 is for a distinct service, 'independent from other services performed on the same day'. For this I looked up the Appendix A in the CPT book.
I hope this is helpful to you. :)
 
I have to disagree. Modifier 59 is the appropriate modifier to use. You must differentiate between the two different biopsies. If you don't use mod-59, then the two biopsies will get bundled together and you will only get paid for one of them.
 
djr5958@hotmail.com said:
I believe modifier -51 is better that -59 in this instance since the procedure is done on the 'same session , same provider' and same approach. Modifier -59 is for a distinct service, 'independent from other services performed on the same day'. For this I looked up the Appendix A in the CPT book.
I hope this is helpful to you. :)
Click to expand...

Mod -59 is the appropriate modifier for "separate biopsies".
 
Thanks, everyone.

Not only did you confirm that I was correct about -50, but it also verified that my suggestion to the doctor to use -59 was right as well.
 
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