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Thread: Modifier 51 vs. Modifier 59

  1. #1

    Default Modifier 51 vs. Modifier 59

    AAPC: Back to School
    A patient presents to the office for removal of three skin tags from his abdomen. During the same session, the physician also excised a benign lesion measuring 3.5 cm from the patient’s nose.

    Would I report modifier 51 or modifier 59 in this case? Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    you might need both. The 59 would be if one procedure is considered bundled with the other, the 51 is used to indicate the second and subsequent procedure in the same session.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3


    You would use modifier 51

  4. #4


    Thanks to both of you for the help!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  5. #5
    Join Date
    Apr 2007
    Greeley, Colorado

    Exclamation Modifier -59

    You would code 11200 and 11444-59. Modifier -59 is used to identify different sites (nose vs abd) and different lesions.
    Lisa Bledsoe, CPC, CPMA

  6. #6

    Red face

    first of all,

    know your carrier! While Medicare no longer requires the use of the 51 modifier, many commercial carriers still want to see it.

    definitely use the 59, 51 is only needed if your Carrier requires it.

    Caprice, CPC

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