Please Explain Use of Mod 59 with Conscious Sedation

[DaveWalker]

Can someone please explain to me the use of modifier 59 attached to Conscious Sedation for endoscopy procedures? When to use it? When to not? Any assistance, advice, or great wisdom is deeply appreciated!!

 

[Deborah Marsh]

Hi - This may depend on the services performed at the encounter, any edits, payer rules, and all that. The Medicare mod 59 article - https://www.cms.gov/medicare/coding/nationalcorrectcodinited/downloads/modifier59.pdf - is a good starting point for general rules, although not specific to your question. The specialty forum members may have some more insights. Good luck!

 

[DaveWalker]

Thank you for the assistance!!