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when to use mod 59

  1. #1
    Default when to use mod 59
    Medical Coding Books
    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?
    Thanks

  2. #2
    Default
    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
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    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

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