Podiatry Coding & Billing Alert

Question: What is the purpose of modifier 59?

Ohio Subscriber

Answer: Depending on certain circumstances, a physician can indicate that a procedure or service was distinct or independent by using modifier 59 (Distinct procedural service). Usually, you would use modifier 59 to identify procedures/services that are not normally reported together, such as:

• A different session, surgery, or site;
• A separate incision/excision, lesion, or injury

Tip: You should use modifier 50 only if no other modifier more appropriately describes the relationship of the two or more procedure codes.

Example: If you have to report 11719 (Trimming of nondystrophic nails, any number) and 11720 (Debridement of nail[s] by any method[s]; one to five), remember that modifier 59 only fits if the trimming and the debridement of the nails are performed on different nails or if the two procedures are performed at separate patient encounters.