Wiki Radiology Coding- consultation with


I didn't think modifier -59 could be used for e/m services. The descriptor is "distinct procedural service". I've never seen it used with e/m codes so just wondering...

Just found the following info regarding the 2008 description of -59 modifier:

59 Distinct Procedural Service: Under certain circumstances, the physician may need it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances. This may represent Documentation must support a different sessionor patient encounter, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same physicianindividual. However, when another already established modifier is appropriate it should be used rather than modifier 59. Only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. Note: Modifier 59 should not be appended to an E/M service.