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Modifier 59 on a Pacemaker Insertion

  1. #1
    Smile Modifier 59 on a Pacemaker Insertion
    Medical Coding Books
    Should you use a modifier 59 on an EKG performed during a pacemaker insertion? We are at odds with our Finance Department as they say this was performed preop but is being placed on the Pacemaker insertion account.
    gprudhoe

  2. Default
    With as much is going on right now with the government and other carriers monitoring the use of modifier 59, your best bet would be to get the EKG report(s) and operative reports and determine if it truly was preoperative, during surgery, etc. It's just my humble opinion to do that, however I would personally want to know all the facts before I put my "John Hancock" on a claim with modifier 59.

    Kris

  3. #3
    Red face
    Quote Originally Posted by koyote View Post
    With as much is going on right now with the government and other carriers monitoring the use of modifier 59, your best bet would be to get the EKG report(s) and operative reports and determine if it truly was preoperative, during surgery, etc. It's just my humble opinion to do that, however I would personally want to know all the facts before I put my "John Hancock" on a claim with modifier 59.

    Kris
    Thank you. This is what we were thinking especially with the RAC's coming.
    gloria

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