tci General Surgery Coding Alert - 2003 Issue 8

Reader Question: Number of Lines Matters for Modifier -59

Question: I reported 10021-59 x 2 for two separate aspirations on the same breast. Medicare denied the second line as a duplicate and paid for one unit only. How should I have coded this? Arkansas Subscriber  Answer: Although you are correct to append modifier -59 (Distinct procedural service) to describe two distinct fine needle aspirations (10021, Fine needle aspiration; without imaging guidance), you did not apply the modifier correctly when submitting your claim form. Most payers want you to report the first unit on a separate line with no modifiers attached. You may report second and subsequent...

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