Wiki Modifier 59 for 70553 and 70544

[Openmri1]

Hello Everybody, I have a dilemma. We usually bill for a Brain MRI with and without contrast 70553 and for a Brain MRA w/o contrast 70544 on the same day of service. According to Medicare under NCCI edits, I can unbundle these services, however, I am not sure If I can use modifier 59? 25? or 51? I thought I could use modifier "59", however Noridian JE Part B aka (Medicare) does not even have modifier 59 listed! Does anyone knows if it is appropriate to use modifier 59 to unbundle those two services????

 

[MarcusM]

http://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/downloads/modifier59.pdf

 

[Openmri1]

Thank you!!!

Thank you Mark! they are done on separate times 30 minutes apart, however it still does not specify if it is ok for me to use for these type of procedures

 

[polycoder]

We use 59 mod for Noridian

 

[Openmri1]

We use 59 mod for Noridian

Hi Polycoder, this is what I found in Noridian and modifier "59" is not listed

https://med.noridianmedicare.com/web/jeb/topics/modifiers

 

[k030876]

Hello Everybody, I have a dilemma. We usually bill for a Brain MRI with and without contrast 70553 and for a Brain MRA w/o contrast 70544 on the same day of service. According to Medicare under NCCI edits, I can unbundle these services, however, I am not sure If I can use modifier 59? 25? or 51? I thought I could use modifier "59", however Noridian JE Part B aka (Medicare) does not even have modifier 59 listed! Does anyone knows if it is appropriate to use modifier 59 to unbundle those two services????

We use 70544-59 anytime we have to bill this combination.
KPhares
Lead Coder
Xray Associates of NM

 

[Openmri1]

thank you!