Wiki Multiple Procedure Reduction with -59

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choppe

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Does anybody know of a Medicare reference on how multiple procedures are paid when using modifier -59? I can't think of any situation where using modifier -59 would not be considered a multiple procedure and, therefore, reduced by 50% as long as it is priced lower on the fee schedule. If you don't have a reference but have examples, I would appreciate the insight!
 
modifier 59 is utilized for seperate and distinct procedures such as in interventional coding when there are multiple seperate vessel selections or stents in both extemities are done. If you are appending a modifier for multiple procedures that modifier is 51
 
Multiple Surgery Discount

The Multiple Surgery Discount is applied because you will not have duplicate (or triplicate) pre- or post-operative care despite performing two distinct procedures in one operative sesion.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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