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use of 59 Modifier for 95806and 95800

Cathryn Posted Fri 15th of January, 2016 18:08:20 PM

We have found multiple results and schools of thought for billing our 2 noghe sleep studies.

On biller has told us that we need to use the 59 modifier when billing two separate nights for take home sleep studies.
Below are the two ways we have been told. Which one is correct and will not fail an audit down the road. 59 modifier is hard to discern.

this is just and example of how to fill out the claim form:

Way one:

01/01/2015 01/01/2015 11 95806 99 59 26 1 250.00

01/02/2015 01/02/2015 11 95806 99 59 26 1 250.00

Second way:

01/01/2015 01/01/2015 11 95806 26 1 250.00

01/02/2015 01/02/2015 11 95806 26 1 250.00

Third way;

01/01/2015 01/02/2015 11 95806 1 250.00

Please help that you. These are home sleep studies done by a oral surgeons and ENT office. to take impressions for sleep appliances.

Christie

SuperCoder Answered Mon 18th of January, 2016 07:16:09 AM

As suggested by you, second way seems to be most accurate for the code 95806, with the information provided.

01/01/2015 01/01/2015 11 95806 26 1 250.00
01/02/2015 01/02/2015 11 95806 26 1 250.00

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