Wiki Mod 51 or 59- Multi. Lesions Removed

mcdream

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When you have more than 1 excised lesion, you code the biggest size lesion first without a modifier, followed by the smaller lesion(s) with a modifier appended. But do you append mod 51 or 59 to ALL remaining excised lesion codes (any add'l excised lesions after the first lesion)?

My thought has been to append 51.

I recently came across a case coded with modifier 59 instead of 51: Excised malignant lesion of 5.0cm right arm, and excised malignant lesion of 0.7cm left arm. This was coded: 11606 first (for the bigger lesion-5.0cm right arm) then coded second was 11601-mod 59 (for the smaller lesion-0.7cm left arm). Rationale for Mod 59 was same anatomic body part (arms) but different sides (right & left).

How would you code this case- mod 59, or mod 51, or mod RT & LT?

Modifier 51 Multiple Procedures indicates that multiple procedures were performed at the same session.
It applies to:
• Different procedures performed at the same session
• A single procedure performed multiple times at different sites
• A single procedure performed multiple times at the same site

Modifier 59 Distinct Procedural Service indicates that a procedure is separate and distinct from another procedure on the same date of service. Typically, this modifier is applied to a procedure code that is not ordinarily paid separately from the first procedure but should be paid per the specifics of the situation.
It applies to:
• Different session or encounter on the same date of service
• Different procedure distinct from the first procedure
• Different anatomic site
• Separate incision, excision, injury or body part

TIA
 
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There is no NCCI edit between the two codes, so the 59 modifier is not necessary. I work for a payer and we don't require the 51 modifier for multiple services.
 
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