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Use of 59 and 51 modifiers TOGETHER?

  1. #1
    Default Use of 59 and 51 modifiers TOGETHER?
    Medical Coding Books
    Our provider did procedures 29881 and 29875 - 59 on a patient. Insurance denied stating 26875 was bundled into 29881. We disagree and are appealing. I ran it through Ingenix and it shows that we should append w/ a 51 not a 59. Someone then stated that we need to append w/ BOTH the 59 and 51. I have never seen these two used simultaneously. Just wanted to see if any of you guys had anything to support that this can be done. This is a Cigna patient.

    Thanks!

  2. #2
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    Default
    Quote Originally Posted by kmonte View Post
    Our provider did procedures 29881 and 29875 - 59 on a patient. Insurance denied stating 26875 was bundled into 29881. We disagree and are appealing. I ran it through Ingenix and it shows that we should append w/ a 51 not a 59. Someone then stated that we need to append w/ BOTH the 59 and 51. I have never seen these two used simultaneously. Just wanted to see if any of you guys had anything to support that this can be done. This is a Cigna patient.

    Thanks!
    You don't report 51 and 59 together. For 29875 you need a 59 mod. Was it in a separate compartment from 29881? If so, appeal, if not it's inclusive..

  3. Default
    Agree you never use mod 51 and 59 together. In the CPT book it states separate procedure so you would use mod 59.

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