When an additional procedure is performed through a separate incision, which normally would not be reportable but is appropriate to report in the particular circumstance, the coder should append modifier:

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Modifier -59 is used to indicate a distinct procedural service, which includes procedures that are not typically reported together but are appropriate under the circumstances. This modifier is often used to signify that a procedure was performed through a separate incision or at a different session, making it distinct from other services provided.

When an Additional Procedure Is Performed Through a Separate Incision