Wiki Use of 59 and 51 modifiers TOGETHER?

[kmonte]

Our provider did procedures 29881 and 29875 - 59 on a patient. Insurance denied stating 26875 was bundled into 29881. We disagree and are appealing. I ran it through Ingenix and it shows that we should append w/ a 51 not a 59. Someone then stated that we need to append w/ BOTH the 59 and 51. I have never seen these two used simultaneously. Just wanted to see if any of you guys had anything to support that this can be done. This is a Cigna patient.

Thanks!

 

[nyyankees]

Our provider did procedures 29881 and 29875 - 59 on a patient. Insurance denied stating 26875 was bundled into 29881. We disagree and are appealing. I ran it through Ingenix and it shows that we should append w/ a 51 not a 59. Someone then stated that we need to append w/ BOTH the 59 and 51. I have never seen these two used simultaneously. Just wanted to see if any of you guys had anything to support that this can be done. This is a Cigna patient.

Thanks!

You don't report 51 and 59 together. For 29875 you need a 59 mod. Was it in a separate compartment from 29881? If so, appeal, if not it's inclusive..

 

[campy1961]

Agree you never use mod 51 and 59 together. In the CPT book it states separate procedure so you would use mod 59.