Use of 59 mod in ER settings

[gladiator0011]

Hopefully someone can send me in the right direction here and if you have a link to a site that states a rule, that would be appreciated as well!

If you have a medicare patient in the ER who has an I&D of an abscess but also has an Infusion for 1hr and 2 IVP's, which CPT would you put the -59 on? I thought it was appropriate to put eh 59 on the infusion and injections but someone new is stating that its easier to just add the 59 to the I&D procedure and it clears the CCI edit for all. It was my belief that the procedure with the 59mod on it would get paid at a reduced rate thats why you put on the injections but then I was told that its not true anymore.

Can anyone verify this and/or send me in the right direction?

 

[mitchellde]

First check the CCI edits and the modifer goes where it needs to be to keep a procedure or service from "bundleing" into another. If you do not use the modifier on the correct code then it will not unbundle the service.