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Orthopedic Coding Alert

READER QUESTION:

Polydactyl Thumb Removal

Published on Fri Nov 01, 2002

Question: Our hand surgeon performed a polydactyl removal of right and left thumbs (no bone). CPT advises using 11200* (Removal of skin tags, multiple fibrocuta-neous tags, any area; up to and including 15 lesions). Should we code this just once, or twice with modifier -59 (Distinct procedural service) appended to the second unit? California Subscriber Answer: Because 11200 refers to "multiple fibrocuta-neous tags" and specifies that it covers up to 15 lesions, you should not bill additional units for the right and left sides, nor should you bill modifier -59 or modifier -50 (Bilateral procedure).

As a rule, if the code descriptor contains the word "multiple," such modifiers are inappropriate and unnecessary. In this case, 11200 should be reported only once with no modifiers.  
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