Reader Question: Multiple Facility Procedures

Question: Which modifiers should we use for multiple facility procedures performed on the same day, for example, multiple pathology specimens a skin biopsy revealing a nevus of the leg and arm? We assumed modifier -59 to explain different sites, but have been advised by two different sources to use -76 and -91.

Indiana Subscriber

Answer: This question was posed at the recent AMA symposium in Chicago and evoked a difference of opinion between the CPT panel and the speaker. We suggest using modifier -59 (distinct procedural servic), which is acceptable in this situation because, as you say, its the same test on a different site. Use modifier -76 (repeat procedure by same physician) if the test was done on the same specimen, which isnt the case in this example. Modifier-91 (repeat clinical diagnostic laboratory test) is only used for clinical laboratory, which doesnt apply here either. You should check your FI about units, however. Some FIs have built in an (OCE) edit for multiple units for pathology codes, and others recommend it.

- Published on 2001-06-01