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59 modifier

Super Posted Thu 08th of July, 2010 17:02:01 PM

is the 59 modifer paid at what procedure level (priamry, secondary)?

SuperCoder Answered Fri 09th of July, 2010 10:31:04 AM

This can be used with either of the procedure, but normally it's to be added to a less extensive Px, compared to a more extensive Px performed at same / different session. But make sure about the use of modifier 59. This modifier should always be used with the Px code present in the "column 2" of CCI edits, and not with column 1 code. And also, you should be sure of the distinct / separately identifiable nature of the Px, to which code you are going to add the mod. Otherwise, even if the 2nd Px code is present in the column 2 of CCI edits and with an indicator "1", still your claim could be denied.

You can refer to the "Modifier Survival Guide" in in order to know more about the applicability of various modifiers.

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