General Surgery Coding Alert

Question: When I code for a bilateral mastectomy, I use modifier 50. But in some cases the mastectomy done on each side is different so the bilateral goes out the door. I am coding for a modified radical 19307 on the left and a simple 19303 on the right. Do I use a modifier 51 or modifier 59 for the second procedure? Minnesota Subscriber Answer: Modifier 59 (Distinct procedural service) is the modifier that will help you out here because it tells the payer that the procedure was performed in a different location (the other breast). You will definitely need the modifier to get paid for both of these procedures. If you don't add a modifier the payer will assume that the surgeon started with a simple mastectomy and then found more extensive disease and did a modified radical mastectomy on the same breast. Remember that you should use modifier [...]