Wiki modifier 51

[kimb]

would it be right to use modifier 51 when a shaving of a lesion was done at the same time as an excision of a benign lesions same side of body and same area. example: 11403 and 11301

thanks for the help
Kim b

 

[007CPC]

I don't think so; maybe

Use:Level two HCPC modifiers, LT, RT; unless the insurance company requires you to utilize level one modifier 51. If the two codes are bundled, use 59 on the code positioned as the indented context ( the code that is bundled into). But then, 11301 may be inclusive into 11403.

 

[Lisa Bledsoe]

If it is a different lesion in a different location, use modifier -59.

 

[kimb]

If it is a different lesion in a different location, use modifier -59.

thanks for your advise

 

[kimb]

shaving of lesion & excision of lesion

Lisa,

The lesion was on the same side of the back. One was a shaving and the other was an excision so that is why I thought I should use modifier 51. If I am understanding the definition for modifier 59 it has to be on a different site.

thanks again

example is: 11403 3.5 cm
11301 - 51 2 cm

This is how I submitted the claim

 

[Lisa Bledsoe]

Technically, if it is a different lesion it is a different site. The definition for -59 in CPT states "separate lesion".
Lisa