modifiers for 19301 & 38525, separate incisions

eutsler

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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.
 

rdodd81

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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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