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59 modifier

J
Wiki 59 modifier

I work for a genetic testing laboratory, we currently bill CPT 81229 (CMA) and 81243 (Fragile-X) together and we have always billed these with a 59 modifier on the 81243 with great success. Recently, we have had a couple of Regence payers deny the 81243 -59 as inappropriate coding combination...
- jbartunek1
- Thread
- May 10, 2018
- 59 modifier 81229 81243 laboratory billing
- Replies: 0
- Forum: Pathology & Clinical Laboratory
V
Wiki 59 modifier

I am billing for a pediatricians office and the doctor bills out for a medical nutrition (97802) and an auditory test (92587), we are not getting reimbursed for these procedures. I added a 59 mod to the CPT code, because sometimes I get a note in the ERA stating this is an unbundled service...
- vickytia13
- Thread
- Oct 11, 2017
- 59 modifier 92587 97802
- Replies: 0
- Forum: Modifiers

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