If multiple lesions are removed from the colon and the procedure is documented as being unusually extensive, you would report modifier and include the amount of time extended beyond the normal time.

If multiple lesions are removed from the colon and the procedure is documented as being unusually extensive, you would report modifier 51 and include the amount of time extended beyond the normal time.

Explanation:

A modifier is like a code by which a physician indicates that the procedure that was being performed has been altered due to some circumstances.  

Modifier 51 is used when multiple procedures are performed in the one session by the same individual. This should not include than E/M services. This means if more than two surgical services are being provided by the physician in one session, modifier 51 is used. The highest paying procedure is listed first, and then subsequent procedures are listed.