Question

Incidental appendectomy during an intra-abdominal surgery does not usually warrant a separate identification. If it is necessary to report a separate identification, how should the service be reported?

Never appropriate if incidental
A) 59
B 57
C) 51

Answer 1

To report an incidental appendectomy done during an intra-abdominal surgery as a separate procedure, one should use modifier -51. However, this is generally not necessary as the payment is usually bundled into the primary procedure unless unique circumstances warrant separate billing.

Step-by-step explanation:

When an incidental appendectomy is performed during intra-abdominal surgery and it is necessary to report it as a separate identification, the correct way to report this service is by using modifier -51. Modifier -51 is used for multiple procedures performed during the same surgical session that are not commonly performed together. In contrast, modifier -59 indicates a distinct procedural service, and modifier -57 is used for decision for surgery. However, most payers including Medicare bundle the payment for incidental appendectomy into the primary procedure, making separate reporting unnecessary unless specific criteria are met that justify its designation as a separate procedure.