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Which Modifier

  1. #1
    Question Which Modifier
    Exam Training Packages
    If you do a colonoscopy and an egd at the same visit, do you use a -51 or a -59?

  2. #2
    Location
    Tacoma
    Posts
    22
    Default RE: modifier
    You'd code the colonoscopy as the first procedure and the egd as second procedure on the egd you'd add the TA with mod 51.

    Example:

    45378
    43239,TA 51

  3. #3
    Default
    What Is The Ta?

  4. #4
    Location
    Amarillo Texas Chapter
    Posts
    12
    Default Modifier 59/51
    Hi,

    As far as my understanding goes it should be reported using a modifier 51 and not 59. As it says do not use modifier 59 when there is an alternative modifier that can explain the scenario.

  5. #5
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    There are some that say no modifier and they get paid for both...but in our practice we use -59 on the EGD. Use -59 because of they are separate procedures (different entrance locations obviously).
    Lisa Bledsoe, CPC, CPMA

  6. #6
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    the TA modifier is not appropriate as that is for the Left Toe..since we are talking EGD and Colonoscopies..for obvious reasons you would not use it.

    As far as the 59 goes, in normal instances it is should not be necessary however you will find some carriers have there own opinions and will want it. Its important to know the carrier idiosyncrasies (thank you Tessa)
    Last edited by mbort; 11-05-2008 at 03:01 PM.

  7. #7
    Default
    I don't use neither one and I get paid anyway. I think they don't need the modifier because both procedure are self explanatory indicating different anatomical sites. I work for an ASC though...
    NoRaX

  8. Default
    Which modifiers would you use if physician performs 45385 and 45380? Would it be inappropriate to use -59 here? Should -51 be used instead?

  9. #9
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338
    Default
    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 would need to put the -59 on this scenario

  10. #10
    Default
    Why wouldn't you code both? The use of both modifiers indcate that multiple procedures were performed due to seperate conditions.
    45380
    45385-51-59

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