You Be the Coder:
Modifiers 51, 52: Focus on What Services Physician Performed
Published on Tue Jan 17, 2012
Question: My ob-gyn did a paratubal cyst excision when done at the time of a c-section. I know to use 4920X based on size, but should I use modifier 52 because the surgeon is already in the abdomen?South Carolina SubscriberAnswer: The answer depends on who performed what service. Same physician: You should not apply modifier 52 (Reduced services) to 4920X (Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; ...). If the same surgeon who did the delivery did the paratubal cyst excision, then you should treat this as a multiple procedure (as in, modifier 51, Multiple procedures). Different physician: However, if a second surgeon did the paratubal cyst excision at the time of the c-section, then you should apply modifier 52 to 4920X.
