Wiki Modifier 59 help

[campbella1]

IBC stopped paying my claims for 2 e/m's (an office visit and preventive visit) and a flu shot . The claims had a 25 modifier on them but now all of a sudden because of NCCI edits I am being told that I have to use a 59 modifier. Is anyone familiar with this modifier - can you tell me if should be attached to an e/m or the non e/m service.

 

[ehanna]

IBC stopped paying my claims for 2 e/m's (an office visit and preventive visit) and a flu shot . The claims had a 25 modifier on them but now all of a sudden because of NCCI edits I am being told that I have to use a 59 modifier. Is anyone familiar with this modifier - can you tell me if should be attached to an e/m or the non e/m service.

When we have this type scenario we use a -25 on the office level and a -59 on the administration code. I hope this helps

 

[campbella1]

Thank you