Wiki Multiple repairs with different lesions

[stogsmom3]

I'm struggling with finding out what modifiers to use. The provider did intermediate repairs on 2 different excision and different body areas. I was going to bill in this order according to RVU: 12041,12031,11422,and 11402. I was thinking 12041,12031-59,11422-51, and 11402-5951.

Any help is appreciated.

 

[JesseL]

I'm struggling with finding out what modifiers to use. The provider did intermediate repairs on 2 different excision and different body areas. I was going to bill in this order according to RVU: 12041,12031,11422,and 11402. I was thinking 12041,12031-59,11422-51, and 11402-5951.

Any help is appreciated.

I would think you don't need a modifier 59 on any of those codes since all the codes description themselves are of different sites.. should be no ncci conflict between those codes but you should double check... you could put modifier 51 on all of the codes, except for the one with the highest RVU which would be 12041.


12041
12031-51
11422-51
11402-51

View RVU's here:
https://www.aapc.com/practice-manag...031,11422,11402,,,,,,,&u=0,0,0,0,0,0,0,0,0,0,

Download the NCCI for physcian's here (scroll all the way down)
http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html

 

[CatchTheWind]

You really should not guess about which codes to put modifiers on. You should either look them up in the CCI edits, or ask your provider to subscribe to a service such as DermCoder that does it for you. (You just type the codes into their website and it comes back telling you which ones need the modifier.)

The correct way to code this is to put a 59 (or XS) on the 12041. If your carrier requires 51 modifiers, it would go on all three of the other lines.