Modifier 59

Modifier 59

June 20, 2019

Question:
I destroyed 8 AKs and 3 SKs on a patient and also took a shave biopsy of another site.  My codes are 17000, 17003 X 7, 17110, and 11102.  Do I use modifier 51 or 59?  I get confused on this issue.

Answer:
Since there are bundling edits for the codes you performed, you would need modifier 59 to appropriately bypass the edits since you performed separate procedures on separate sites.  Modifier 51 is not a modifier that allows you to bypass the NCCI edits.  According to the NCCI edits, you would want to append modifier 59 CPT to codes 17000 and 11102 to appropriately bypass bundling issues.  So, you would report 17110, 17000-59, 17003 X 7, 11102-59.

*This response is based on the best information available as of 06/20/19.

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