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Modifier 51 with modifier 59 or X modifiers

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Kpope2565

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Fuquay Varina, NC
Is there any specific guidance that states you should or should not code these modifiers on the same CPT code? I have seen opinions on this but no actual guidance. Any help would be greatly appreciated.
Thank you!
 
I don't think your going to find any either. Modifier -51 just indicates that it's an additional surgical procedure. The only time that -51 would not be used would be on "Add-On" codes such as 29826. I'm not sure what your issue or question is, modifiers -59 & -X modifiers just indicate that two surgical procedures that could be bundled are not and both are paired with -51 out of necessity. CMS created the -X modifiers about six years ago and some private payers are starting to use them too, but not all do.
 
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