Again, a 59 modifier is not being stuck on anything to get it out the door, it depends on what your specific carrier wants. BCBS in Pennsylvania wants units, some specific workers comp carriers want line by line with a 59 on the additional unit code, for example 22614, 22614 59. A 59 on a code does not warrant 100% of allowable payment if billed on 2 primary procedure codes such as 22630 and 63047 59. (You would get 50% of the allowable for 63047). 59 is just being used to indicate that the secondary procedure is being done at a different site, body area or for a different disease or condition. If I would bill 22614 and 22614 59, I would expect 100% of the allowable for both codes as they are both modifier 51 exempt procedures. For more clarification on this issue, and other spinal coding issues, I would suggest attending the American Association of Neurological Surgeons Reimbursement and Coding Challenges educational seminar. Again, in the AANS seminar we are told for 51 exempt codes to either bill as 22614 x 2 or 22614 and 22614 59 depending on your insurance carrier. The presenters at this seminar have a lot of coding experience and some sit on the CPT Assistant Editorial Panel and serve as liasons to the AANS/CNS Coding and Reimbursement Committee so I highly doubt that they would give incorrect advice. Again, I would check with your individual insurance carriers as to how they want additional units billed. Billing as units or billing per line item with a 59 on the second duplicate code is not incorrect coding.
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