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another modifier 51 or 59 question for you!

  1. Default another modifier 51 or 59 question for you!
    Medical Coding Books
    If the doctor provides treatment of wound (12021) on four separate wounds how is this coded? Would modifier 51 apply here?

    12021
    12021-51
    12021-51 etc.


    also I would like to know if it is ever acceptable to code one line with multiple quantities with modifier 51 appended. like this

    12021 x 4- 51

    I disagreed with another biller earlier saying that I don't think that is appropriate but I just want to make sure that I understand fully.

    thanks for your help

  2. #2
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    Columbia, MO
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    You will need the 59 to keep the line items from being considered a duplicate entry. you should not use units so list as
    12021
    12021 59
    12021 59
    12021 59

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
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    Madison Area Chapter in Madison WI
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    Default
    Quote Originally Posted by mitchellde View Post
    You will need the 59 to keep the line items from being considered a duplicate entry. you should not use units so list as
    12021
    12021 59
    12021 59
    12021 59
    Debra - I have a follow-up question for you on this one.

    Would multiple surgery reductions be applied to the secondary codes even if they have a Modifier 59? Thanks.
    Happy Coding, Claudia


    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    [email]ccrsconsulting@tds.net
    ccrsconsulting.com - website

  4. #4
    Location
    Columbia, MO
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    Yes they will discount as they are suppose to.if you have a payer that still needs the 51 then code as
    12021
    12021 59 51
    12021 59 51
    12021 59 51

    Debra A. Mitchell, MSPH, CPC-H

  5. Default
    Look into CPT 2011 book on page 65 : Instructions for listing services at time of wound repair: #2 when multiple wounds are repair..............
    Aurora Gonzalez Alvarez, CPC

  6. #6
    Location
    Columbia, MO
    Posts
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    OK I had a dull moment! I am sooooo sorry, I was not paying attention as I was just looking at your modifier.. When coding wound repairs of the same type in the same area you add the lengths together and code only one repair code so you would not have multiple line items. Thank You Aurora for the kick in the head!

    Debra A. Mitchell, MSPH, CPC-H

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