59 Modifier - ECHO, stress tests, nuclear scans

Kathy B.

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Regarding in office testing (ECHO, stress tests, nuclear scans, etc), are we supposed to bill these on the same claim forms or separate ones if they were done on the same day for 1 patient?

If we can bill on the same form, are we to attach a 59 modifier? I am aware of using the 59 modifiers in the hospital, just not in the office.

Also, any comments regarding the fact that billing of 59 modifiers can be problematic?

Any advise is appreciated!!
 

jewlz0879

True Blue
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Richardson, TX
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Regarding in office testing (ECHO, stress tests, nuclear scans, etc), are we supposed to bill these on the same claim forms or separate ones if they were done on the same day for 1 patient?

If we can bill on the same form, are we to attach a 59 modifier? I am aware of using the 59 modifiers in the hospital, just not in the office.

Also, any comments regarding the fact that billing of 59 modifiers can be problematic?

Any advise is appreciated!!
We bill them separately but that is how our reports come in. If you were to bill a Echo and TEE on the same day and same claim form you shouldn't need a modifier 59 because they are not bundled. Now if a Nuc and SE were done on the same say, which would be weird, I would bill them separately because they both have the stress component to bill. You could bill them together and put a modifier 59 on there as well but I think it might create more problems. We seem to get paid doing it the way we have set up.
 
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