Assuming there is medical necessity for both procedures, modifier -59 is acceptable per current quarter NCCI edits. CMS guidelines provides the following information related to this similar topic:
"EXAMPLES OF MODIFIER -59 USAGE
Example: Column 1 Code/Column 2 Code 11055/11720
CPT Code 11055 - Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion CPT Code 11720 â€“ Debridement of nail(s) by any
method(s); one to five
Policy: Mutually exclusive procedures
Modifier -59 is:
1) Only appropriate if procedures are performed for lesions anatomically
separate from one another or if procedures are performed at separate
2) Donâ€™t report CPT codes 11055-11057 for removal of hyperkeratotic skin
adjacent to nails needing debridement."
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join