59 modifier

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!!
 

DocAssist

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Kathy, I don't bill your specialty but if you can give me the procedure codes I can tell you more about adding 59. The documentation has to show that the procedures are seperate and identifiable. You can go to the CCI Edits on the Medicare, not sure which state you are in, but the CCI Edits will tell you if the codes are bundled together and whether a mod 59 can be added to show as a seperate procedure.
 
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