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Use of modifier 59

  1. #1
    Question Use of modifier 59
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    I am working on billing for a urologist. When he bills a 52000, 51741, and 51798 all together, do I need to add a 59 modifier on two of the charges?

  2. #2
    Location
    Ellenville, New York
    Posts
    1,176
    Default No, you don't
    I ran the codes through our system checking for CCI edits - all three may be billed together without the modifier -59. You may have been confused by the "separate procedure" description on 52000. Since the EMG or post-voiding measurement described by the other are separate and the cysto is not part of them, there is no need for -59.

  3. #3
    Question Modifier 59
    So do the CCI edits only show the codes that either require modifiers, or that are not allowed to be billed together with modifiers? Their spreadsheet is confusing. When i enter these codes, it doesn't show them listed together to let me know about modifiers.

  4. #4
    Location
    Ellenville, New York
    Posts
    1,176
    Default
    Quote Originally Posted by Kellyj0h View Post
    So do the CCI edits only show the codes that either require modifiers, or that are not allowed to be billed together with modifiers? Their spreadsheet is confusing. When i enter these codes, it doesn't show them listed together to let me know about modifiers.
    Our editor shows both - either that you can't bill the codes together or that you can, but a modifier would be needed. I got none of those messages with any combination of your three codes.

  5. Default modifier
    Hello

    i work convenient clininc and we are billing to Medicaid. Our porviders are Np or PA. To submit claims to Medicaid i need a modifier to show that the services are rendered by NP
    Does anybody knows about modifiers?? Please advise.

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