Those codes are not bundled so you will not need a -59. Only use -59 when procedures are bundled (per NCCI or payers policy) and you can show procedures were separate and distinct from each other. If a procedure is required to do the more extensive procedure and is bundled, you don't want to unbundler or use -59. Incorrect or over usage can raise red flags for an audit. Be very careful when and how you use -59.
-51 just indicates 2 or more procedures were performed. Add-on are -51 exempt.
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