tci Outpatient Facility Coding Alert - 2015 Issue 11

Modifier Review: Know Your Modifier 59 Better for Cleaner Claims

Modifier 59 (Distinct procedural service) is used when two codes are not normally reported together (for instance, one code may be bundled with the other), but may be billed together under certain circumstances (for instance, if the two procedures occurred at different anatomic locations during the same patient encounter). Modifier 59 is the “modifier of last resort” because you should append it only when no other modifier is more appropriate (e.g., modifiers to describe laterality, such as LT, RT, and 50), and documentation supports a distinct or independent service. Therefore, check before appending modifier 59, beginning with...

To read the full article, sign in and subscribe to tci Outpatient Facility Coding Alert.


TCI's Outpatient Facility Coding Alert helps your facility stay profitable by covering issues that are important to you — everything from billing strategies and appropriate payment indicators to coding tips and tricks, analysis of industry trends, and so much more. Subscribe today and let our experts make your job easier.

  • Current newsletters added each month
  • Fully searchable archives - over 650 articles
  • ALL years/issues back to 2012 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Outpatient Facility Coding Alert +Archives

free demo
request yours today
pricing
for any budget
sign IN
welcome back!