Forum - Questions & Answers
Dermatology and Modifier 59
I am new to Dermatology and I am having trouble with Healthsprings over the modifier 59 or 51. I have listed a scenerio below if someone can advise. procedures are done on seperate lessions or anatomical sites. where and what modifiers would you use?
99203 25 701.9
17000 702.11
17003 702.11
17110 59 702.0
11100 238.2
Dermatology and Modifier 59
[I am new to Dermatology and I am having trouble with Healthsprings over the modifier 59 or 51. I have listed a scenerio below if someone can advise. procedures are done on seperate lessions or anatomical sites. where and what modifiers would you use?
99203 25 701.9
17000 702.11
17003 702.11
17110 59 702.0
11100 238.2
]
Derm/mod 59
99202-25
17000
+17003
17110-59
11100-59
There are cci edits on 17000,17110 and 11100...so you would need the 59 on two of the three to keep them from bundling. 17003 is an add on code, so doesn't need a modifier. Your dx codes should support that they were different lesions.
51 is rarely used anymore for multiple procedures. I am not familiar with Healthsprings, so I am not sure what their policy is...but I have not used a "51" in atleast 3 years. You can still use it, and it shouldn't harm claim. You use -59 when there are bundling issues per CCI.
Placement of 59 modifier
I would bill as follows:
99202-25
17110
17000-59
17003
11100-59