# modifier 59 with add-on codes??



## LaSeille (Jan 28, 2013)

This has never been an issue until 2013.   Medicare is now denying payment on our add-on codes stating that they need a modifier 59 in order to be paid.   49568 is an add-on code that can be billed with ventrial hernia repair 49560 is warranted.  However, now M/C is denying and when we called and spoke w/ CS rep, she said it needed a modifier.  We then asked for a supervisor who stated same.  They are saying it is in the 2013 CCI edits and that they must go by what the edits say.  We told them the edits must be wrong for 2013 becuz this was never an issue before, but...they will not back down.    This is also happening for another add-on code, 15777.   Anyone having same problem or know what the issue is???


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## ollielooya (Jan 28, 2013)

We've encountered this with one of the major payers here in Washington State too.  They ALSO want the modifier 59 on the add-on codes.  Thought it strange as normally this wouldn't be the case.


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