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Mod 51 versus 59

  1. Default Mod 51 versus 59
    Medical Coding Books
    When charging out for 45378 colonoscopy and 43235 upper gi endoscopy on the same dos. Do I use mod 51 or mod 59. Some of the coders her say 51 the others say 59. Please help!!

    Nichole

  2. #2
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    North Carolina
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    According the CCI edits, these services are not bundled. Modifier 51 would be attached to 43235.

    http://www.cms.gov/NationalCorrectCo...CCIEP/list.asp

  3. #3
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    Quote Originally Posted by cnramsey View Post
    When charging out for 45378 colonoscopy and 43235 upper gi endoscopy on the same dos. Do I use mod 51 or mod 59. Some of the coders her say 51 the others say 59. Please help!!

    Nichole
    There is no reason to need the 59 modifer on either of these procedures since by definition they are already distinct and separate... You cannot perform an exam of the esophagus with a colonoscopic approach! You MIGHT need a 51 but only if both are performed in the same session and only if the payer still recognizes the 51.

    Debra A. Mitchell, MSPH, CPC-H

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