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Thread: 59 modifier

  1. #1

    Default 59 modifier

    AAPC: Back to School
    Is it appropriate to put a 59 modifier on an add-on code? If so, where could I find this in writing? Thank You

  2. #2
    Join Date
    Apr 2007
    Fort Wayne, IN


    I don't believe you can put a modifier on an add on code
    Tracy Hecox, CPC

  3. #3
    Join Date
    Apr 2007
    North Carolina


    Unfortunately, some carriers create edits that require some non-conventional coding tactics. I do have some carriers that will deny an additional "add on" code as a duplicate. It's very clear to me that I'm trying to report multiples levels (example-spine case) but there are occasions when the carrier does deny them without modifier 59. I am one who uses modifier 59 cautiously but there are carriers who obviously don't hold the same standard.

    I have found one CPT Assistant (December 1999) that provided a case study. This case study happened to be a spine case. One of the CPT codes discussed was 22851 (which is an "add on" code). This particular CPT Assistant suggested submitting the 2nd 22851 with modifier 59 to indicate that the instumentation was placed at a separate identifiable site.

    This may be a situation where this will vary from carrier to carrier...

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