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According to the guidelines we also need a modifier 59, and that is because the guidelines say, “When more than one classification of wounds is repaired, list the more complicated as the primary procedure, and the less complicated as the secondary procedure, using modifier 59.” Actually, what you would do is that 13121 would go first, and the remaining four codes (12034, 13122, 12011, 12002) would each have a modifier 59 on them to show that they are separate and significant from one another

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