tci General Surgery Coding Alert - 2000 Issue 5

Reader Question: Second Procedures Billed With Modifier -59

Question: On occasion, a patient needs both an upper and lower endoscopy (EGD and colonoscopy) for different reasons (e.g., duodenal ulcer and history of polyps or anemia). As a courtesy to the patient, I perform both of these procedures at the same setting, yet reimbursement is always 50 percent on the second endoscopy. What is the correct way to bill for these procedures to get full reimbursement?Michigan Subscriber  Answer: Any time multiple procedures are performed on the same day, even if they are designated as distinct by attaching modifier -59 (distinct procedural service) to one of...

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