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Wiki Modifier -59

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Summer

Networker
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Cape Coral, FL
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Hello,

Verifying, if a modifier -59 is placed on a cardic cath and billed with a stent placement on the same day, the heart cath will be reimbursed at 50% of the fee schedule and the stent placement will be paid at full fee - correct?

Thank you in advance.
Summer
 
Hi Summer,

The 51 modifier is automatically reduced by 50%. Depending on the payer a 59 could reduce the payment by 50% as well.. Some payers don't decrease because of a 59. We ususally have to send in documentation and they make the determination from there.
 
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