• If performing 67101 and 67145 during same surgical session, appropriate to append modifier -59 and bill both procedures?


    If we are performing 67101 and 67145 during the same surgical session, is it appropriate to append modifier -59 and bill both procedures? I know there is a CCI edit. We’re trying to determine if it meets the definition of modifier -59. It’s same site, same session, I’m leaning towards we should adjust off one of the charges.

    You are correct. It is not appropriate to unbundle as it is considered same structure.