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Correct Coding

  1. Default Correct Coding
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    I recently started working for a dermatologist, they have been billing 11100-59 with 17000 no modifier. although I am new to this wouldn't the 59 go on the second procedure not the first? I was told it was done this way to keep the first procedure from being reduced. When there are multiple procedures would there only be one mod 59 placed?
    example: 99212-25
    Thank you in advance for any help you can give me.


  2. #2
    Jacksonville, Florida - 90417
    Default Correct Coding
    The 59 modifier is appended to the procedure code or codes listed in column 2of the NCCI edits. The 59 modifier (when allowed and properly supported) will allow the procedure code (s) to which it is (are) appended to pay. Without the 59 modifier, the procedure code listed in column 2 would deny as included in the allowance of the corresponding column 1 procedure code.

    In your example, procedure code 11100 is in column 2 and procedure code 17000 is in column 1. Therefore, the 59 modifier it should be appended to procedure code 11100.

    Hope this helps.

    Maryann C. Palmeter, CPC, CENTC, CPCO

  3. Smile Thank you
    Thank you very much, your reply is very helpful

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