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Wiki modifiers for 19301 & 38525, separate incisions

E

eutsler

Networker
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Location
Minerva Park, OH
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My surgeons frequently perform the lumpectomy and SLNB through separate incisions. There are no CCI edits for these two codes. Would you use a -51 or a -59 on 38525? Have you found that different insurances have different requirements?

I've been using -59 without issues, and I think I started due to problems with a payer, but someone recently told me I should be using -51. No other procedures are being performed by the surgeons.
 
One of my surgeons performs the same surgery. We don't put either modifier on 38525 and haven't any problems with reimbursement. Hope that helps
 
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