Wiki 59 Modifer

[Pat Liebl]

In the CCI book under cpt 62225 the Critical care cpt 99291 is shaded under it which mean they are bundled when you do the reverse look up 62225 is not under the 99291. Do I put the 59md on the 99291 even though that is being billed first Thank You

 

[shellysk8]

Correct Modifier

Hi,

Since 99291 falls into the E&M range of services, a 59 modifier would not be appropriate, it would be a 25 modifier. Of course, sufficient documentation would be necessary. CPT does not indicate that 62225 is one of the included services, but if CCI edits do, then the modifier 25 should be appended to the 99291.

Thanks,
Shelly L. Kubacki, MPA, CPC