Wiki Modifier 51 and 59 - A few questions regarding

[grizzlylover]

A few questions regarding these two modifiers.

I work for an orthopedic surgeon. He did a 29827, 29826, and 29824. Modifier 51 was added to 29826 and 29824 but medicare denied the 29826 due to inconsistent modifier. Do you add a 51 to this code. According to the CPT book it is not modifier 51 exempt. Any help would be greatly appreciated.

Secondly, when do you use a modifier 59? Can anyone clarify on this?

 

[donna_vig]

29826 is an add-on code to 29827 and is Mod-51 exempt. No modifier required. Mod-51 should be attached to 29824.

 

[jplichta]

You are correct that according to the CPT book 29826 is not mod 51 exempt, but if you check the 29826 in the global book it says to NOT use mod 51 for medicare. We just had this discussion in my office yesterday as it is very confusing.