Podiatry Coding & Billing Alert

Not adhering to the correct criteria could get you 'red flagged.'A modifier in the right place at the right time is likely to get you a prompt and fair reimbursement. You use one of the most important modifiers - modifier 59 (Distinct procedural service) -- so often that you think you know everything there is to know about it. Review essential facts about modifier 59 and avoid hitting a blank wall before it's too late.Guideline 1: Know Modifier 59's Criteria When You See ItThe right combination of a podiatrist's procedure and a modifier can make or break your claim. If you want to be able to interpret a modifier correctly, read it like a story. Through modifiers, payers know what transpired during a procedure without having to go read every operative report, says Susan Ward, CPC, CPC-H, CPC-I, CPCD, CEMC, CPRC, coding and billing manager in Phoenix.In the case of modifier 59, [...]