by Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
March 3rd, 2017
There are certain procedures that are carried out in addition to the primary procedure called add-on codes. They describe a specific type of supplemental procedure done in addition that are labeled as add-on codes.
The AMA gives instructions and guidelines with notations such as "List separately in addition to primary procedure" or "each additional". You will also see a "+" sign or icon next to the procedure code.
Example of an add-on code:
Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT)
These type of codes cannot be reported alone or as a stand alone code and are also exempt from the modifier 51 (Multiple Procedures). Using modifier 51 will not pass NCCI edits. Incorrect use of modifiers can be considered fraudulent or abusive.
Modifier 59 (Distinct Procedural Service) would also not apply to an add on code. The description of modifier 59 indicates "documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual." Although there may be times when the modifier 59 may be required. For example, if there was another procedure done in addition.
Note: Be sure you watch for bundling edits anytime you use this modifier.