AAPC - Back to school
Results 1 to 3 of 3

Thread: when to use mod 59

  1. #1

    Default when to use mod 59

    AAPC: Back to School
    When coding 45385 and 45381, the NCCI edits on the medicare website, do not list these two codes together. So, does that mean, to use mod 51 instead of 59?

  2. #2
    Join Date
    Apr 2007


    These codes are not bundled according to CCI guidelines, so a modifier 59 is not necessary to bill them together. Modifier 51 is used unless the payer has instructed you not to use it. (Palmetto GBA, for one, does not want the 51 modifier for multiple procedures.)
    Jenny Berkshire, CPC, CEMC, CGIC

  3. #3
    Join Date
    Apr 2007
    Greeley, Colorado


    Jenny is correct. Mod -51 would go on CPT 45381. You do not need to use modifier -51 for Medicare, as they will append it for you.
    Lisa Bledsoe, CPC, CPMA

Similar Threads

  1. Mod 51 vs Mod 59 for ASC use
    By Tracy592 in forum Modifiers
    Replies: 3
    Last Post: 07-08-2015, 12:49 PM
  2. mod 62 denied can I use mod 80?
    By fisher.jaimie@gmail.com in forum Modifiers
    Replies: 6
    Last Post: 05-18-2015, 05:27 AM
  3. Mod 25
    By dpumford in forum Modifiers
    Replies: 2
    Last Post: 09-06-2011, 11:08 AM
  4. mod 25 - Can anyone shed some light on this
    By iovine in forum Billing/Reimbursement
    Replies: 4
    Last Post: 08-26-2011, 06:32 AM
  5. mod 25 & mod 59 with a 94664 (inhaler)
    By jsa1517 in forum Modifiers
    Replies: 2
    Last Post: 01-29-2010, 02:46 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.