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modifier 51 or 59?

  1. Exclamation modifier 51 or 59?
    Medical Coding Books
    Medicare patient had 2 11301 (shave excisions) done both on same leg. One was .75cm the other .5cm. Patient also had 17000 (AK destruction) done on face. Would I code the one with the highest RVU's first and then use modifier -51 on the other procedures? Or would I use modifier -59? Any comments would be welcome.

  2. #2
    Location
    Modesto, CA; Central Valley Chapter
    Posts
    225
    Default
    Medicare in our area does not want the -51, so I would use 59.

    Tina

  3. #3
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    When coding a separate lesion - always use modifier -59 for distinct procedural service.

  4. Default
    Thank you very much! This is the first time i've used this forum and I'm finding it very useful

  5. Default Medicare CCI edits
    You should check with your Medicare CCI edits that can be found on the web site, it will tell you which code should have the modifer applied.

  6. Default
    Yeap and report most extensive lesion first with no modifier, then least extensive lesion w/modifier

  7. Default
    http://www.cms.hhs.gov/NationalCorrectCodInitEd/ link to the CCI Edit link on the CMS website.

    Quote Originally Posted by EKMineau View Post
    You should check with your Medicare CCI edits that can be found on the web site, it will tell you which code should have the modifer applied.

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