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tci Part B Insider - 2004 Issue 29
-59 Modifier Under Scrutiny, Expert Warns
The -59 modifier may get your claims paid, but you could be storing up a world of hurt for later if you overuse it. "It's overused just to get through the edits," consultant Annette Grady with Eide Bailly in Bismarck, ND says of the -59 modifier. It's often hard to figure out when to use -59appropriately, but it's vital to do so. The Centers for Medicare & Medicaid Services is currently looking closely at -59, Grady believes. While each carrier and payor has different claims review software, it's a safe assumption that many carriers will single...
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Keep pace with evolving Medicare regulations with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI’s Part B Insider will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, the fee schedule, OIG target areas, and more.
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