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Attn cgic specialty

  1. #1
    Default Attn cgic specialty
    Medical Coding Books
    On codes 43235 and 43450 do you use an 59 or not?
    On codes 43239 and 43450 do you use an 59 or not?
    Medicare requires you to use an 51 and i don't understand why but on the physician side billing do you use a 59 or not cause those codes are the same part of the body

  2. Default
    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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