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51/59 Clarification PLEASE!!!!!

  1. Default 51/59 Clarification PLEASE!!!!!
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    My office is in desparate need of the whole 51/59 modifiers. We know what they mean but if we have a Doctor that performs 29881 and 29879, do we use 51 or 59 if it is that same knee. The codes are not in CCI. Thanks!

  2. #2
    Location
    Columbia, MO
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    If they are not bundled then use the 51 to indicated the procedures were performed at the same time. You will not need the 59 because it is already recognized that by definition the procedures are distinct and separate.

    Debra A. Mitchell, MSPH, CPC-H

  3. Default
    Just want to make sure I have this right. We should use a 51 in this case but we would use the 59 if the surgery involved a knee scope AND and shoulder scope? This is so fustrating

  4. #4
    Location
    Columbia, MO
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    no because the knee scope will state knee and the shoulder scope will state shoulder so by definition the scopes are in two separate areas and need no further distinction to make them separate.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
    Location
    High Point, NC
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    84
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    Try to think of modifier 59 as the "unbundling" modifier. You only need to use this modifier when you need to "unbundle" procedures that are bundled per CCI edits. Just make sure your documentation supports the unbundling.

    Hope this helps.
    Cindy Gallimore, CPC, CENTC

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