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Wiki Orthopedics and Modifiers

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Melissa Cartwright CPC

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Oklahoma City, OK
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I am billing these three codes and am wanting to know opinions on the -59 and -51 mods on the 27437 and any feedback on this surgery in general. Thanks

27446
27437 59-51
20985

all of these on the same claim for the same patient, this is one surgery. Thanks
 
Basing my response on just the NCCI edits on the CMS website.

https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/NCCI-Coding-Edits.html

27437
27446 -59
20985

The 27437 & 27446 relationship shows that the 27446 is a column 2 code with an indicator of 1.
Indicator 1 means a modifier is allowed in this code relationship & the modifier belongs on the column 2 code.

As always make sure the operative note documentation supports billing each code. Also, anatomical (RT/LT) modifiers might be needed..
 
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