tci Outpatient Facility Coding Alert - 2014 Issue 7
Modifier Review: Brace Yourself with Modifier 59 for Distinct Procedural Services
Refer to Medicare’s Correct Coding Initiative (CCI) before using Modifier 59 Modifier 59 (Distinct procedural service) indicates that two services which are generally not reported separately are appropriately reported separately under the circumstances not ordinarily encountered or performed on the same day by the same individual. You report modifier 59 when there is a: Different encounter or session; Different procedure; Different site; or Separate incision, excision, injury, lesion, or body part. Starting point: The first step in determining whether modifier 59 is needed is to refer to Medicare’s Correct Coding Initiative (CCI). The CCI lists code...
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