Modifiers:
Avoid Attaching Modifier 59 to the Wrong Code with These 2 Tips
Published on Wed Oct 10, 2012
Pointer: Correct your claims if you realize you have been doing it wrong.Now that you have read about when you can and can't break the latest Correct Coding Initiative (CCI) bundles using a modifier in "Include I&D, Skin Suture Procedures With Your Urological Surgery Codes, Thanks to CCI 18.3", you should make sure you know how to properly use modifier 59 (Distinct procedural service) on your claims. Payers are still scrutinizing submissions for separate and distinct services, thanks to the OIG's reported error rates relating to modifier 59 use. But you can avoid these coding errors and prevent possible paybacks by using these two tips.Tip 1: Determine Separate RegionsPull a sample of your modifier 59 submissions and verify that the claims properly represent a distinct procedural service. Fifteen percent of the OIG's audited claims using modifier 59 had procedures that weren't distinct because "they were performed at the same session, [...]