In Coding
Jul 8th, 2019
Although coding in this area may seem complex, you can simplify it with a quick review of requirements and carrier policies. Coding for spinal cord stimulation lead implantation is thought to be too complex and difficult for some. There are several reasons for this perception: There are coding differences based on the site of service ...
In Coding
Jul 8th, 2019
When you have distinct, separate procedures, know which modifiers will get the claim paid in full. Modifier 59 Distinct procedural service acts as a “universal unbundling” modifier for procedures that are normally included as part of another procedure, or “bundled.” The modifier tells the payer that there are special circumstances that warrant separate reporting (and ...
In Coding
Feb 5th, 2019
Call on AAPC Coder and NCCI code pair edits for support. Many procedures in the CPT® code book are designated “separate procedures,” but that doesn’t mean you can report those procedures separately in every case. First, you must consider other procedures performed during the same encounter. “Separate” Might Not Mean What You Think It Does ...
In Coding
Dec 13th, 2018
Modifier 59 Distinct procedural service is an “unbundling modifier.” When properly applied, it allows you to separately report—and to be reimbursed for—two or more procedures that normally would not be billed or paid independently during the same provider/patient encounter. For example, per CPT Assistant(Jan. 2018): Code 20680 [Removal of implant; deep (eg, buried wire, pin, screw, metal band, ...
In Coding
Jan 29th, 2018
When I last wrote “Modifier 59 – To Use or Not to Use”, I promised to follow it up with some real-life examples of when we should be using the 59 or the new Medicare X[ESPU] modifiers. Let’s look at some clinical examples and first determine if the 59 is applicable, and then assume it ...