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Help! Modifiers!

  1. #1
    Default Help! Modifiers!
    Medical Coding Books
    How do you know which code to apply the modifier EX: 59
    A Right Hemicolectomy; along with small bowel resection?
    Where do you find the answers? Thank you

  2. #2
    Post I haven't done CPT in a while but I'll give it a shot
    Quote Originally Posted by Hopp View Post
    How do you know which code to apply the modifier EX: 59
    A Right Hemicolectomy; along with small bowel resection?
    Where do you find the answers? Thank you
    My coding is book is outdated, but one of the two elements: the "hemicolectomy" along with "resection" are most likely considered bundled according to the CCI. And because of some certain circumstance, the physician feels it is necessary to report "one of the two elements(procedures)" as an exclusive service from each other, despite what the CCI says; do to the definition of modifier 59 in appendix A of CPT.

    I hope this is clear, if not, I am sure another coder will explain the use more transparently this Monday.

  3. Default
    Check to see if the procedures are bundled. If they are not, then I would list the procedure with the highest reimbursement first followed by the other procedure with the -59 modifier.

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