Internal Medicine Coding Alert

You Be the Coder:

Choose Between -51 and -59 for Wound Sites

Question: Should we use modifier -51 or modifier  -59 to report multiple wound repairs on different sites?

Indiana Subscriber

Answer: To choose between modifiers -51 (Multiple procedures) and -59 (Distinct procedural service) for claims with multiple laceration repair codes, first determine if the National Correct Coding Initiative (NCCI) bundles the codes. 
 
If no NCCI bundle exits, use modifier -51. "When more than one classification of wounds is repaired," CPT directs you to use modifier -51. If the NCCI bundles the claimed codes, however, you should instead report modifier -59 to override the edit. Otherwise, the payer, if it follows the edits, will reject the component code as bundled into the more comprehensive code.

Other Articles in this issue of

Internal Medicine Coding Alert

View All