Wiki 59 modifier - Can you bill 96361,96366,96367,96368 and 96375

smithca

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Can you bill 96361,96366,96367,96368 and 96375 with 59 modifier to Medicare? I have checked the edits and was not able to find any information?
 
No 96361, 96366, 96367, & 96368 do not need 59 modifiers because they are add-on codes (in their description it states they are additional sequential infusions/pushes). But the 96375 will need a 59 with certain codes like 36593, 38221 or 62270. Hope this helps.
-Stephanie
 
Hello,

I just wanted to add to the last posting. Yes all of the other codes are add on codes. You would need an initial code or else all will be denied. You have to determine which drug was administered first and the times in order to get the correct code. Judging by the codes you have listed looks like that 96367 may become 96365 depending on what non chemo meds were given first.

Hope this helps,
LL
 
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