Wiki Modifier for Dermatology Excisions and Repairs being billed together

[tonienuse]

As a general rule, and I correct in using -51 on the Excision code when both procedures are billed together in the same visit? Or should it be -59? I've been told either, but that doesn't seem correct. Thanks for your help!!

 

[iowagirl77]

The modifiers should not be interchangeable. If the two procedures bundle, determine if they were done for the same site; in this case you would not bill both charges. If the procedures bundle but are at different sites you should be able to append a modifier (59 or XS) to indicate why they are each separately payable. If the procedures do not bundle, you can put the 51 modifier with the secondary procedure (although it isn't needed if the second code is an add-on code).

 

[Barbiejean]

excisions with repairs

The only time I put a -51 on either code was if it was a Medicare claim and my claim scrubber needed it. The repair code is usually the higher RVU so that should go first then the excision code. If it is the same location, (and it doesn't fall under the "simple" repair category) you shouldn't need 51 or 59 on either code. If you are doing multiple locations in one surgical setting then you would need the 59 modifier.