Wiki Modifier 25/59

[REGINALD068]

Happy New Year Fellow Coders!!

Can someone please confirm if this is correct.

99214 - 25
20553 - 59

I am under the impression 59 is applied to separate other NON E/M services, Not to separate from an actual E/M. Please advise

 

[CodingKing]

59 would not be used in this case as there is only one surgical procedure billed. It's only to be used if there are two surgical procedures that have NCCI edit . Also to bill the 25 on the E&M it needs to be significant and separately identifiable. Minor E&M is included in all minor surgical procedures (0 & 10 day globals)

 

[REGINALD068]

Thank you. Billing Director is instructing to bill claim out as such. We are constantly on the edge because she insists she's coding correctly. The book clearly states 59 is for other NON E/M services. She just received her certification, but it's hard to believe she passed. This is basic and she's instructing the Dept incorrectly.