tci General Surgery Coding Alert - 2001 Issue 1

Reader Question: Modifier -59 or -51?

Question: What is the difference between modifiers -59 and -51? During preparation for the CPC exam, I read that when a physician performs an esophagogastroduodenoscopy (EGD) and a colonoscopy on the same day, modifier -51 is used to indicate multiple procedures. Would modifier -59, which fits the description of two separate anatomical sites for two separate problems/diagnoses, be appropriate in this case? We have been advised, however, that modifier -59 can trigger an audit. Can you clarify?Oregon SubscriberAnswer: The descriptor for modifier -59 (distinct procedural service) states that it should be used for procedures/services that are not normally...

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