AAPC - Back to school
Results 1 to 2 of 2

Thread: Use of 59 mod in ER settings

  1. #1

    Default Use of 59 mod in ER settings

    AAPC: Back to School
    Hopefully someone can send me in the right direction here and if you have a link to a site that states a rule, that would be appreciated as well!

    If you have a medicare patient in the ER who has an I&D of an abscess but also has an Infusion for 1hr and 2 IVP's, which CPT would you put the -59 on? I thought it was appropriate to put eh 59 on the infusion and injections but someone new is stating that its easier to just add the 59 to the I&D procedure and it clears the CCI edit for all. It was my belief that the procedure with the 59mod on it would get paid at a reduced rate thats why you put on the injections but then I was told that its not true anymore.

    Can anyone verify this and/or send me in the right direction?

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    First check the CCI edits and the modifer goes where it needs to be to keep a procedure or service from "bundleing" into another. If you do not use the modifier on the correct code then it will not unbundle the service.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Mod 51 vs Mod 59 for ASC use
    By Tracy592 in forum Modifiers
    Replies: 3
    Last Post: 07-08-2015, 12:49 PM
  2. 26432 in office settings
    By viksash in forum Orthopaedics
    Replies: 1
    Last Post: 04-02-2015, 08:02 AM
  3. Testing if my discussion settings work.
    By nbetts2000 in forum Diagnosis Coding
    Replies: 0
    Last Post: 03-31-2015, 02:05 PM
  4. mod 25 & mod 59 with a 94664 (inhaler)
    By jsa1517 in forum Modifiers
    Replies: 2
    Last Post: 01-29-2010, 02:46 PM
  5. E/M in inpatient settings
    By member7 in forum E/M
    Replies: 1
    Last Post: 02-28-2008, 08:34 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.