JenLawson
Networker
There is a CCI conflict between 50590 ESWL and 52005 ureteral catheter. A modifier is allowed to override the conflict when documentation supports.
Does anyone have any insight on what documentation is required to support the use of a modifier?
I am stuck on the definition of mod 59 - 'Documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury not ordinarily encountered or performed on the same day by the same individual.'
And the coding tip in the Coding Companion:
Report 52005 if the physician uses the cystourethroscope for examination and catheterization only. ... When 52005 is performed with another separately identifiable procedure, the highest dollar value code is listed as the primary procedure and subsequent procedures are appended with modifier 51.
My doctors are performing the cysto and cath placement in conjunction with ESWL. After the shockwave treatment is completed they remove the catheter. They can do the ESWL without the catheter or with stent placement instead. Based on this would use of modifier 59 be supported?
Thank you,
Jennifer
Does anyone have any insight on what documentation is required to support the use of a modifier?
I am stuck on the definition of mod 59 - 'Documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury not ordinarily encountered or performed on the same day by the same individual.'
And the coding tip in the Coding Companion:
Report 52005 if the physician uses the cystourethroscope for examination and catheterization only. ... When 52005 is performed with another separately identifiable procedure, the highest dollar value code is listed as the primary procedure and subsequent procedures are appended with modifier 51.
My doctors are performing the cysto and cath placement in conjunction with ESWL. After the shockwave treatment is completed they remove the catheter. They can do the ESWL without the catheter or with stent placement instead. Based on this would use of modifier 59 be supported?
Thank you,
Jennifer
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