Wiki Coding Multiple Procedures on Multiple Digits

[lora.a.cherry@gmail.com]

I'm some what of a novice to the Coding Profession can someone please assist we with coding order and proper assignment when multiple digits are involved. The patient has open fx and open wounds to 4 digits. My concern is for optimal reimbursement. Should I code the most complicated digit first with the proper modifiers per guidelines and the remaining digits with a 59 to indicate that they are separate ? Any help would be appreciated.

 

[OCD_coder]

Excellent question at the perfect time, the beginning of your career. You would report your CPT codes from Highest RVU to lowest in descending order by DOS. Only apply modifier 59 if it is indicated. What this means is that if the codes bundle and meet the requirements for Modifier 59, then it is applicable. If you're talking about fingers, the F-modifiers would identify that they are different fingers and eliminate the need for modifier 59 use. See your HCPCS book for FA-F9 modifiers and what digits they apply to. Toes are TA-T9.

Modifier 51 is carrier specific, most carriers automatically apply it when the claim is received via electronic. I use it, just because I am a bit OCD and like to be absolutely correct.

Here is the link that I like to refer to identify if the scenario meets Modifier 59 requirements and is applicable/reportable:
http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/downloads/modifier59.pdf

 

[lora.a.cherry@gmail.com]

Thank you so very much for your response.