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Cpt 41874 help

  1. #1
    Default Cpt 41874 help
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    I have a claim and op note for 41874 x3 quadrants...provider billing 41874, 41874-59 and 41874-59...

    The description of code states EACH quadrant, so does 59 apply or does 51 apply?????
    Marilyn CPC, CPC-H, CEMC

  2. #2

    I am not sure what state you are in; however, here is the link to a National Coverage Policy I found on the Michigan website:

    I am going to give you another link below. I think the way you identify the quadrants as stated in the CPT book is with your ICD-9 codes. Read the information in the following link and you will see what I mean. I do not feel modifier -59 or -51 are needed because the code is telling you to specify the quadrants.

    Here is the other link:

    Read the ICD-9 codes and you will get what I am saying about identifying the quadrants with the diagnosis codes.

    Peggy Kulczycki, CPC, CPC-I

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