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59 modifier with laceration repair

  1. #1
    Default 59 modifier with laceration repair
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    CPT 2012 states "When more than one classification of wounds is reparied, list the more complicated as the primary procedure and the less compicated as the secondary procedure, using modifier 59." Previously modifier 51 would have been used in this case. Is CMS ready for this scenario to be represented by the 59 modifier?

  2. #2
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    Quote Originally Posted by kbartrom View Post
    CPT 2012 states "When more than one classification of wounds is reparied, list the more complicated as the primary procedure and the less compicated as the secondary procedure, using modifier 59." Previously modifier 51 would have been used in this case. Is CMS ready for this scenario to be represented by the 59 modifier?
    You might have to check with your local Medicare carrier to be sure, but if it is in the CPT guidelines for 2012 then CMS should be ready for it.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  3. #3
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    Quote Originally Posted by kbartrom View Post
    CPT 2012 states "When more than one classification of wounds is reparied, list the more complicated as the primary procedure and the less compicated as the secondary procedure, using modifier 59." Previously modifier 51 would have been used in this case. Is CMS ready for this scenario to be represented by the 59 modifier?
    it has always been a 59 modifier to prevent bundleing if you have an intermediate repair and a simple repair in the same define area but different sites you use the 59 modifer or the simple will be bundled into the intermediate. if the two repairs are in different defined areas then you use the 51.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
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    CPT 2011 stated "When more than one classification of wounds is repaired, list the more complicated as the primary procedure and the less compicated as the secondary procedure, using modifier 51." It doesn't read as if it distinguishes between same anatomic sites or different sites.

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