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Modifier 59 Use

B

bluemoon1

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A pt has a chemo infusion from 9am to 10am. Following the chemo the pt
has a hydration infusion from 10am to 11am. Would the hydration infusion
have a modifier 59 attached to it. Thank you for your help
 
96361 is not bundled with 96413 so modifier 59 should not be required. If the hydration was infused on the same DOS as the chemo infusion via a different site or during a different encounter (same DOS) and the hydration was reported as an initial service, 96360, modifier 59 would be required.
 
I would normally agree with the Mod-59 not being required for the 96361 with the 96413, but I have had a few payor's that bundle any hydration at the same "event" and require a mod-59. So it can be payor driven at times.

Have your payor provide a policy that states those requirements though.
 
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