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Hydration and Port flush on same day

  1. Default Hydration and Port flush on same day
    Medical Coding Books
    Patient comes in for hydration and port is clogged, we admisister CathFlo and then proceed with hydration.
    Current claim is 96360-59 x 1, 96361 x2 and 36593-59 and J2997. My question is why would we use -59 modifier twice. This is all the patient received in the Infusion center (hospital based clinic).

  2. #2
    Modifier 59 is used to report services that are not generally reported together, but are necessary for certain situations. It's not a "usual" scenario, at least according to most insurance companies, for the patient to come in for hydration and have a clogged port that needs to be flushed. That's why you would use the 59 modifier - to show that you did in fact perform both services on the same encounter. Even though you are using the 59 modifier, a lot of insurance companies will consider the flush as incidental to accessing the port for the hydration & won't pay. Good luck though!

  3. Default hydration an port flush
    I understand why we use -59 but my question is should both services have a -59 modifer attached or should only one service have it? Patient came in for hydration and we discoverd the port needed to be flushed. Wouldn't the port flush CPT be the only one with the -59 modifier, not both services?

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