AMA CPT® Assistant - 2002 Issue 6 (June)
Modifier -59 vs Modifier -91 (June 2002)
June 2002 pages 1-3 Modifier -59 vs Modifier -91 Since the introduction of modifier -91, many questions have been raised regarding its use vs modifier -59. Some third-party payers have suggested that modifier -91 can be appended to every laboratory code that is reported more than one time on the same date of service. However, per the CPT coding guidelines, this is not the appropriate method of reporting modifier -91. The purpose of this article is to clarify some of the confusion surrounding the reporting of modifier -91 and modifier -59. We will discuss the intent of these two...
Subscribe or sign in to view the full article.
Article Overview
This CPT® Assistant article focuses on the reporting distinction between modifier -59 and modifier -91 in the context of outpatient laboratory services. It is intended for coders, billers, and laboratory billing staff who need a clearer understanding of when these modifiers are discussed in CPT guidance and how they relate to repeated testing, separate specimens, and microbiology reporting. The article includes narrative explanation, microbiology-related guidance, and several clinical vignettes that show the general reporting scenarios addressed by the modifiers.
Why This Topic Matters
Modifier selection can affect whether services are recognized as separate, distinct, or repeat laboratory tests. This article helps readers identify the types of situations covered by CPT guidance so they can better interpret premium coding education on laboratory reporting.
Article Sections
-
June 2002 pages 1-3
Introductory publication information and an overview of the article’s focus on two modifiers used in laboratory reporting.
-
Modifier -59, Distinct Procedural Service
Discussion of modifier -59 within the broader context of distinct or separate services and laboratory reporting considerations.
-
Modifier -91, Repeat Clinical Diagnostic Laboratory Test
Discussion of modifier -91 as it relates to repeated laboratory testing on the same date of service and the surrounding CPT guidance.
-
Microbiology guidelines
CPT microbiology guidance addressing repeated laboratory testing, multiple specimens, and related reporting concepts.
-
Clinical Vignette: Use of Modifier -59
A laboratory reporting vignette illustrating the broader distinct-service scenario discussed in the article.
-
Clinical Vignette #1: Use of Modifier -91
A laboratory reporting vignette illustrating the repeat-testing scenario discussed in the article.
-
Clinical Vignette #2
A second laboratory reporting vignette addressing repeated testing within the same date of service.
What You Will Learn
- The general purpose of modifier -59 in CPT laboratory and outpatient reporting
- The general purpose of modifier -91 in repeat clinical diagnostic laboratory testing
- How CPT microbiology guidance is presented in relation to these modifiers
- The types of laboratory scenarios discussed in the article’s clinical vignettes
Who Should Read This
- Medical coders
- Laboratory billing staff
- Practice administrators
- Compliance staff
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com
