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modifier 51

  1. #1
    Talking modifier 51
    Medical Coding Books
    would it be right to use modifier 51 when a shaving of a lesion was done at the same time as an excision of a benign lesions same side of body and same area. example: 11403 and 11301

    thanks for the help
    Kim b

  2. #2
    Post I don't think so; maybe
    Use:Level two HCPC modifiers, LT, RT; unless the insurance company requires you to utilize level one modifier 51. If the two codes are bundled, use 59 on the code positioned as the indented context ( the code that is bundled into). But then, 11301 may be inclusive into 11403.

  3. #3
    Greeley, Colorado
    If it is a different lesion in a different location, use modifier -59.

  4. #4
    Quote Originally Posted by Lisa Curtis View Post
    If it is a different lesion in a different location, use modifier -59.
    thanks for your advise

  5. #5
    Red face shaving of lesion & excision of lesion

    The lesion was on the same side of the back. One was a shaving and the other was an excision so that is why I thought I should use modifier 51. If I am understanding the definition for modifier 59 it has to be on a different site.

    thanks again

    example is: 11403 3.5 cm
    11301 - 51 2 cm

    This is how I submitted the claim

  6. #6
    Greeley, Colorado
    Technically, if it is a different lesion it is a different site. The definition for -59 in CPT states "separate lesion".

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