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please help with this

  1. #1
    Default please help with this
    Clearnace Sale
    We are auditing a few charts where the edits are asking for a -59 modifier and I am leary of using that particular modifier, right now especially.

    I have a pt that came in the ER. She had sever back pain and the doc started an IV and administered fentanyl (twice throughout) and ativan and then proceeded to give two injections to the sac area (20610). I am trying to decide if a -59 is should be used here. In the CCI edits it has a 1 (and I know that the CCI edits are not always right) so it can be unbundled if appropriate. My question is, she was probably going to receive pain meds for her pain regardless, but in the dictation, he states "I performed bilateral injections of both sac joints after 25mg of fentanyl and .5 of ativan" so I would consider that as part of the procedure and the 96374 &75 need to be removed, right? my co-worker thinks that the -59 would be allowed in this case. Who is right on this one?

  2. #2
    Modesto California
    20610 is a different injection site and procedure, the 59 modifier should be used.

  3. #3

  4. #4
    Columbia, MO
    I am going to agree that it is appropriate based on the information it appears that there were 2 different things done.

    Debra A. Mitchell, MSPH, CPC-H

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