You do not need to use modifier 59 when performing an eval and neuro re-ed. They are already distinct procedures. If the patient has therapeutic exerise in addition to aquatic therapy on the same day, you would bill 97110 and 97113-59 to signify that two distinct therapeutic exercises were done that day. Other than that, you will rarely need to use modifier 59 for therapeutic procedures as they are already distinct procedures.
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