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Which Modifier

  1. #11
    Greeley, Colorado
    Medical Coding Books
    Quote Originally Posted by maysons1703 View Post
    Why wouldn't you code both? The use of both modifiers indcate that multiple procedures were performed due to seperate conditions.
    You use -59 because it is a separate lesion/polyp. 51 would indicate that you did a bx and a polypectomy on the same polyp, in which case you would only get paid for one procedure. Also, CCI edits state -59.
    Lisa Bledsoe, CPC, CPMA

  2. Default
    If you are using 45380 amd 45385 your documentation better support that these were done in different locations otherwise 45380 is included in 45385.
    And I never use a modifier on an EGD and Colonoscopy and I always get paid.
    adrianne, cpc

  3. #13
    I dont use a modifier either when I code an EGD and colo. Never had any issues with payment. I believe the procedure codes themselves tell the insurance company that they are "distinct procedural services". They are obviously done from different "openings" and the majority of the time you will probably be using a different diagnosis.
    Susie Corrado, CPC
    ENT Coding/Billing

  4. #14
    Default Modifiers
    51 And 59 Are Mutually Exclusive. You Never Use Both On The Same Line.

  5. Smile
    Quote Originally Posted by ncantello View Post
    Which modifiers would you use if physician performs 45385 and 45380? Would it be inappropriate to use -59 here? Should -51 be used instead?
    You can 59 modifier with 45380


  6. #16
    the ta is to represent a turn around procedure

  7. #17
    In my practice if a dr. performs and colonoscopy and egd same day, we use mod-51...

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