Forum - Questions & Answers

Sep 7th, 2011 - harmijo 8 

Multiple procedures

Please tell me if I did this right: An elderly patient came in for eyelid laceration and repair was done. The PA also did a nail trim for dystrophic nails. I coded the visit with a CPT® of 11720 and eyelid repair of 12051 with -59. IS an E/M still needed for this visit? Did I use the correct codes as far as Modifiers with the correct CPT® code? Please help. Not too bright when it comes to bundling/unbundling. Thanks a bunch!!!

0 Votes - Sign in to vote or reply.
Sep 7th, 2011 - jschmutz   323 

re: MULTIPLE PROCEDURES

11720 and 12051 are not bundled so the lower valued code would get a 51 modifier. If the patient was seen for other reasons then the laceration repair and nail trim, then yes, the E/M is separately reportable.

0 Votes - Sign in to vote or reply.
Sep 7th, 2011 - harmijo 8 

re: MULTIPLE PROCEDURES

So just leave the 12051 with a -59 and add an E/M?

0 Votes - Sign in to vote or reply.
Sep 7th, 2011 - DebraS   67 

re: MULTIPLE PROCEDURES

-59 modifier is used for when the procedure(s) "are" bundled and you can prove it was a separate site, organ sytem, etc... and not bundled. A -51 modifier is for multiple procedures (not bundled) and not used for add-on codes. Note above reply.

0 Votes - Sign in to vote or reply.


About Codapedia by InnoviHealth Systems Contact Us Terms of Use Privacy Policy Advertise with Us

Codapedia™ by InnoviHealth Systems™ - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain) - Fax (801) 770-4428

Copyright © 2009-2019 Find A Code, LLC - CPT® copyright American Medical Association