modifier 59 is correct. Per medicare's NCCI edits, cpt 92980 & 93458 can be billed together with a 59 modifier appended to cpt 93458.
The NCCI edits can be found on CMS medicare website http://www.cms.gov/NationalCorrectCo...asp?listpage=2
WPS Medicare website also has some helpful modifier info.
WPS medicare states the following regarding modifier 59:
Distinct Procedural Service identifies procedures/services not normally reported together, but appropriately billable under the circumstances.
Documentation indicates two separate procedures performed on the same day by the same physician Represented by a different session or patient encounter, different procedure or surgery, different site, or separate injury (or area of injury)Use Modifier 59 with the secondary, additional or lesser procedure of combinations listed in Correct Coding Initiative (CCI) edits.
Use Modifier 59 when there is NO other appropriate modifier. "
I hope this helps.
Alaina M. Boncher, CPC
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