Wiki Modifier 59 or 51?

[kellit21]

My physician performed an arthroscopic partial medial menisectomy and an open excision of ganglion cyst in knee. How would you code this? Would you add a 59 or 51 modifier to one of the cpt codes?

 

[twizzle]

My physician performed an arthroscopic partial medial menisectomy and an open excision of ganglion cyst in knee. How would you code this? Would you add a 59 or 51 modifier to one of the cpt codes?

I would say the codes are probably bundled, (but can be unbundled) therefore you would use 59 if the report supports unbundling. If they were not bundled per payer policy, you would use 51 on the open code.

 

[kellit21]

I would say the codes are probably bundled, (but can be unbundled) therefore you would use 59 if the report supports unbundling. If they were not bundled per payer policy, you would use 51 on the open code.

The denial reads Per CPT, the code is reported with another service that would be medically improbable and contradictory in.

I guess I am getting confused because the medial menisectomy was by scope and then the excision of cyst was open, therefore, I thought it would be considered 2 seperate procedures.

 

[kellit21]

Any Ideas???