Modifier 59
I've read various posts regarding this modifier and basically, the point seems to be stay away from modifier 59. However, I have a situation which seems to warrant its use. Our ophthalmologist...
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Did you check the National correct coding initiative for the respective quarter (as per the DOS) and see if modifier can be used. I dont have access to the same right now. you can find it in...
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Thank you for your quick response! Yes, I checked CCI edits and the superscript indicates a modifier can be used to differentiate services. Just not really familiar with CCI edits and have never used...
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If modifier can be used, then you could resubmit the claim with modifier 59 in the first modifier field instead of sending a covering letter or other stuff..$0.02
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Usually, if you use a 59 modifier, the payer will require you to submit documentation, so your claim would probably end up on paper anyway.-59 modifier is not really as scary as some people make it...
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www.ericacodes.com/Unbundling.htmwww.cms.hhs.gov/NationalC...fier59.pdf Erica
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Erica, thank you for your in-depth response. I believe I understand the issue of bundling/unbundling and the use of modifier 59 more clearly now, but need additional clarification from the physician...
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