# Mod - 50: please help settle a disagreement



## MnTwins29 (Feb 19, 2010)

A physician has been sending superbills for thyroid biopsies with modifier -50 because he has taken samples from both the left and right side.  I say that this cannot have modifier -50 because the thyroid is not a paired organ - there is only one thyroid gland.  Who, if either of us, is correct?


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## Walker22 (Feb 19, 2010)

What is the CPT code? I can use the RBRVS to see if a bilat modifier is allowed.


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## MnTwins29 (Feb 19, 2010)

*CPT code*

60100 - did this on both sides.  Thank you.


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## slrollings (Feb 19, 2010)

You are correct. The body does not have a right and left thyroid gland, so you should not use the -50. It would be x2.


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## Walker22 (Feb 22, 2010)

According to the RBRVS, 60100 is not eligible for mod-50.


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## Lisa Bledsoe (Feb 22, 2010)

I would code 60100 and 60100-59 since the biopsies are from different sites of the thyroid gland.


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## djr5958@hotmail.com (Mar 1, 2010)

*Modifier 51 instead of 59 in this instance.*

I believe modifier -51 is better that -59 in this instance since the procedure is done on the 'same session , same provider' and same approach.  Modifier -59 is for a distinct  service, 'independent from other services performed on the same day'.  For this I looked up the Appendix A in the CPT book.
I hope this is helpful to you.


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## Walker22 (Mar 1, 2010)

I have to disagree. Modifier 59 is the appropriate modifier to use. You must differentiate between the two different biopsies. If you don't use mod-59, then the two biopsies will get bundled together and you will only get paid for one of them.


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## Lisa Bledsoe (Mar 1, 2010)

djr5958@hotmail.com said:


> I believe modifier -51 is better that -59 in this instance since the procedure is done on the 'same session , same provider' and same approach.  Modifier -59 is for a distinct  service, 'independent from other services performed on the same day'.  For this I looked up the Appendix A in the CPT book.
> I hope this is helpful to you.



Mod -59 is the appropriate modifier for "separate biopsies".


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## dballard2004 (Mar 1, 2010)

I would report mod -59 as well.  These are separate and distinct procedures.


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## MnTwins29 (Mar 9, 2010)

*Thanks, everyone.*

Not only did you confirm that I was correct about -50, but it also verified that my suggestion to the doctor to use -59 was right as well.


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