Wiki modifier 59 oncology

[fmshero1]

a patient has aetna medicare and had a infusion the medicine was billed to pharmacy but the injection was billed to medical, aetna medicare denied for no medication what would be the proper modifier to apply on a corrected claim to aetna medicare for the injection? One thought was a 59 to show separate service any advice would be appreciated.

 

[thranowski]

I file medications/vaccines we aren't billing for with a $0 charge (or $.01 charge if your system does not allow $0 charges on claims) along with the injection administration codes. If there is an E&M I append -25 on it with injections (vaccines or medications) but no modifiers on the injections themselves. Ex:

Line 1 - RX CPT $0.00 (or $0.01)
Line 2 - 96372 $25.00