Anesthesia Coding Alert

Separate sites, modifier indicators hold clues to proper use. When your physician performs two medically necessary procedures during the same session, knowing the ins and outs of modifier 59 is essential for your coding. The problem: Modifier 59 (Distinct procedural service) is one of the most misunderstood modifiers. Avoid problems -- and get your claims paid -- by following these proven tips: Tip 1: Know When to Use Modifier 59 The Office of Inspector General (OIG) and many payers, including Medicare, continually review physicians' modifier 59 use. There are circumstances when you can -- and should -- use modifier 59, however. For instance, you may use modifier 59 to identify procedures that are distinctly separate from another procedure provided by your physician on the same day. In addition, you may append 59 to your claim when your physician: sees a patient during a different session, treats a different site or organ system, makes a separate incision/excision, [...]