Part B Insider (Multispecialty) Coding Alert

Modifier Decision Tree:

Go With the Flow to Make Your Modifier 59 Decisions Easier

Published on Sat Jul 19, 2008

This handy chart can help you decide whether modifier 59 applies to your claim

Your physician performs two separate procedures that are bundled together under the Correct Coding Initiative (CCI) edits. The bundle has a status of "1," so you can break the bundle with a modifier. You append modifier 59 (Distinct procedural service) to the bundled code, because that's the only one you can use -- right?

Actually, no, and this common pitfall sidetracks even the sharpest of coders. Don't rely exclusively on "the modifier of last resort" (modifier 59). This handy flowchart will help you determine your modifier options and select the right modifiers for the case (see page 217 for more modifier 59 tips).

Part B Insider (Multispecialty) Coding Alert

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