modifier 59 versus ??

[megantun13]

The coder before I came used a modifier 59 on EVERYTHING and I'm pretty sure some of those should have been a 51 or even just the "toe" codes.
Is there a guideline for using a 59 on multiple procedures instead of a 51?

Example:
28296 RT
28310 51 RT
28285 T2
Any advice is appreciated.

 

[amottice]

modifier 59

Modifier 59 is used to identify procedures/services that are commonly bundled together but are appropriate to report separately under some circumstances. A health care provider may need to use modifier 59 to indicate that a procedure or service was distinct or independent from other services performed on the same day. This commonly means a different location, different anatomical site, and/or a different session.

www.cms.gov/.../Downloads/modifier59.pdf -----> go to this site for better explanation of modifier 59. There a many changes coming up effect January 2015 of the use of modifier 59 as well. Hope this helps!

 

[PLAIDMAN]

The coder before I came used a modifier 59 on EVERYTHING and I'm pretty sure some of those should have been a 51 or even just the "toe" codes.
Is there a guideline for using a 59 on multiple procedures instead of a 51?

Example:
28296 RT
28310 51 RT
28285 T2
Any advice is appreciated.

you cannot code 28310. the 28296 includes metatarsal osteotomy

I would code this:
28296 RT
28285 59,T2 (separate toe)