Wiki Modifier 59 on stones in different sites of the kidney

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tdove

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I just read an article in the Urology Times that if a Laser Lithotripsy is done in the kidney for stones for more than one stone in different parts of the kidney that you can bill 52353 and 52353 with modifier 59.

Do you think this would be correct because Noridian Medicare Medlearn states you can use modifier 59 for different anatomic sites/organs?

I am a little hesitate to get on board with this and want to know your thoughts out there.

Thanks Tammy
 
Modifier -59 and kidney stones

This makes perfect sense to me. The CPT code is written for a single stone and the wRVU value assigned accordingly. If the surgeon is treating more than one stone, there is more work involved. The separate site definition in the modifier explanation or by extension, a separate lesion can be applied here. Additionally, I would also feel comfortable in using this modifer when stones are treated with PCNL in different parts of the same kidney since the CPT code language is for a single stone; nephrolithotomy, not nephrolithotomies.
A. Hai, R.N., RNFA, CPC, CUC, ACS-UR
 
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