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Thread: 59, 51 modifier

  1. #1

    Default 59, 51 modifier

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    I am coding for dermatology and need help with modifiers for lesion removals.

    Primary code is an excision. Second code is a shaving. There was NO office visit code.
    Physician marked 59 modifier on the excision code and 51 modifier on the second.
    I felt the initial code would not have a modifier and the second would have a 59 modifier.
    How would you code this?

  2. #2
    Join Date
    Apr 2007
    Location
    Albany
    Posts
    171

    Default

    agree with you. In this situation, the primary does not need a modifier and the 59 on the secondary is appropriate.
    Melissa Tescher, CPC, CPMA, CEMC Compliance and Coding Specialist
    Willamette Valley Professional Services member National Advisory Board 2013-2015

  3. #3

    Default

    Linda,

    You must access the CCI (Correct Coding Iniative) to determine which service gets the modifier 59. This is updated quarterly, and there never seems to be any rhyme or reason to this unbundling madness.

    Also, I have never used a 51 modifier in 15 years of derm coding. All our carriers' software attache it on their end.

    If you can post your codes, I would be happy to check CCI for your 59 modifiers.

    Cindy Blount, CPC-D

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