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modifier 51 and 59

  1. Default modifier 51 and 59
    Medical Coding Books
    I am currently studying to take the cpc exam and I am somewhat confused with the modifiers 51 and 59. Can anyone give me an easy explanation when to use these? To me they seem very similiar and they are confusing me

  2. #2
    Columbia, MO
    51 modifier is for physician use only, it is used on the second and subsequent procedure code(s) to indicate when they have been performed in the same procedural session as the first procedure. Its purpose it to indicate that multiple procedure discounting should take place.
    59 modifier is applicable when two procedures are performed and could be component of comprehensive code or could be mutually exclusive, the modifier will negate this edit and allow for both procedures as documentation can support that no bundling should take place such as separate site, separate organ, separate incision. If the definition alone indicates the two procedures are already separate then you do not need the 59.

    Debra A. Mitchell, MSPH, CPC-H

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