tci Part B Insider - 2009 Issue 29

PART B MYTHBUSTER: Look at All Other Options Before Using Modifier 59

Remember that modifier 59 can't solve all your unbundling woes. Myth: Modifier 59 is an easy way to collect when you bill bundled procedures together, and allows you to gain extra reimbursement for your claims any time the Correct Coding Initiative (CCI) bundles procedures together. Reality: In many cases, other modifiers represent your services more appropriately than modifier 59 (Distinct procedural service) -- and in other instances, no modifier will apply to your claim, and you'll instead have to accept the fact that two procedures might be bundled. To avoid running afoul of CMS regulators, always be sure the...

To read the full article, sign in and subscribe to tci Part B Insider.


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.

  • Current newsletters added each month
  • Fully searchable archives - over 4800 articles
  • ALL years/issues back to 2003 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 Part B Insider +Archives

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