Wiki IS A MODIFIER 59 REQUIRED?

[JENIFERCCC]

I currently bill for a medical practice whose main market is workers compensation. In this world it is very unbalanced when it comes to being paid according to what is coded. Sometimes we get paid and sometimes we get denied, it depends on how the adjuster felt that day. With that being said, a biller billed an 62321 with 72275. Is a modifier 59 required with this code? and with what literature can we appeal any denials?, if needed.

 

[csperoni]

Those 2 codes are column 2 NCCI edits. This means you may use a modifier to override UNDER APPROPRIATE CIRCUMSTANCES.
62321 Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT)
72275 Epidurography, radiological supervision and interpretation
This is not my area of expertise, but it seems since 62321 includes imaging guidance, you would have to make a very good case with appropriate documentation to believe -59 (or -X__) is an appropriate circumstance.