Which code does the 59 modifier go on?

Modifier 59 should be used to distinguish a different session or patient encounter, or a different procedure or surgery, or a different anatomical site, or a separate injury. It should also be used when an intravenous (IV) protocol calls for two separate IV sites.

What does a 59 modifier do?

Modifier 59 is used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances.

What code would you report for a cervical approach of a Mediastinotomy with exploration drainage removal of foreign body or biopsy?

CPT codes 39000 and 39010 describe mediastinotomy by cervical or thoracic approaches respectively with “exploration, drainage, removal of foreign body, or biopsy.” Exploration of the surgical field is not separately reportable with another procedure performed in the surgical field.

Does CPT code 31237 need a modifier?

31237 – nasal/sinus endoscopy, surgical with biopsy, polypectomy, or debridement (separate procedure). Use modifier 52 to indicate the decreased level of service provided as a Post Op FESS procedure (31237-52 LT, or 31237-52 RT or to indicate bilateral procedure 31237-52-50).

Does Medicare accept modifier 59?

Modifier 59 is not going away and will continue to be a valid modifier, according to Medicare. However, modifier 59 should NOT be used when a more appropriate modifier, like a XE, XP, XS or XU modifier, is available. Certain codes that are prone to incorrect billing may also require one of the new modifiers.

Can CPT code 31237 be billed bilaterally?

The CPT codes in questions were 31237 and 31237-50. The “-50” is the bilateral modifier, signifying the procedure was performed bilaterally and by appending this modifier the reimbursement is increased. Debridement is the removal of unhealthy tissue and, when performed, warrants use of the debridement code.

Does modifier 59 affect reimbursement?

Modifier 59 allows you to unbundle — separately report and get paid for — two or more procedures occurring during the same encounter by the same physician that would not normally be paid independently. Use modifier 59 correctly, and you’ll collect every penny of reimbursement for the work you do.

How many modifiers should be appended to CPT code 10021?

Modifier 51 should be appended to the secondary procedure which will indicate that multiple procedures were done by same physician on the same day. CPT code 10021 is bundled into CPT code 32405 with modifier indicator 1; therefore, 59 modifiers should be appended to column 2 code 10021 to override bundling.

When to use modifier 59 in a procedure code?

More than one line with modifier 59 appended to the same procedure code requires submission of supporting information/documentation on the claim. Use modifier 59 to identify procedures or services not normally reported together but is appropriate under certain clinical circumstances.

Can you code 10022 more than once?

For the same lesion, 10022 cannot be coded twice. But if multiple locations are aspirated, you can report 10022 twice for each location. Also, you should append Modifier 59 for the second code. Can 38505 and 10022 be billed together?

Is 76536 being billed the same way as 10022?

Yes 76536 is being billed the same way. Thanks for the help with 10022. I was thinking of add mod 59 but didn’t want to do so unless I was perfectly clear about the mod 50 issue. Yes same session sorry for the double post. I also work with an Endocrinoligist who bills the 10022. We bill this code on a single line using the Modifiers 76 & 59.