Wiki Modifier 59 Help!

[TMB1965]

I work in Opthalmology, and my doctor wants me to bill the 66982-79-54 with the 67010- 79- 54-51. According to the NCCI Edits these 2 codes are bundled, and then I called Medicare, and they confirmed that modifier 59 would have to be used, but my question is if its the same anatomic site and same encounter it can't be used. I told my doctor this and he insisted on billing the modifier 51. Any suggestions on where I can go to print out the info for these two procedures being billed together. I have been googling and everything I'm coming across is from 2006, 2007, 2011, 2012. There's got to be a print out for 2014 on this.

 

[mhammy67]

http://www.supercoder.com/my-ask-an...al-of-retained-lense-fragment-3-wee#post-8505


http://www.ophthalmicprofessional.com/articleviewer.aspx?articleID=108893

http://www.eyeworld.org/printarticle.php?id=4044



Here is a couple of links to look at. I have always gone by the rule if it was a preplanned vit with cataract removal then I break the bundle with a -59 but the op note must indicate that. Also we have a doc that does these procedures together for pediatric patients and I break the bundle. If the vit is done because of prolapse due to cataract surgery, I do NOT break the bundle.

Hope this helps