You Be the Coder:
Modifier 51 vs. Modifier 59
Published on Tue Oct 27, 2009
Question: I am coding four different debridement sites on the foot but they are all at different areas. I am planning to use 11043 times three and 11040 once. I intend to add modifier 51 to all the codes except the first 11043. Is this correct coding, or is modifier 59 more appropriate? Tennessee Subscriber Answer: You are correct about the procedures codes you'll report: 11043 (Debridement; skin, subcutaneous tissue, and muscle) and 11040 (Debridement; skin, partial thickness). However, you should not be using modifier 51 (Multiple procedures). Instead, you should be using modifier 59 (Distinct procedural service). Here is what your coding should look like: • 11043 • 11043-59 • 11043-59 • 11040-59. The reasoning: You should use modifier 59 to identify procedures that are distinctly separate from any other procedure your surgeon provides on the same date. Specifically, CPT -- backed by guidelines found in Chapter 1 of the [...]
