Wiki Modifier 59 on column 2 code with "0" indicator on NCCI

[Mklaubauf]

Hi,
My physician did 45990 and 46040 at the same time. He did 45990 due to the fact that he was not sure what exactly he was dealing wiht.

On the CCI edits 45990 is column 2 with "0" meaning no modifier allowed. However, can I still use 59 if we were doing for diagnositic reasons?

This is for a third party payor.

Any thoughts please.
Marci

 

[mitchellde]

Sorry but no. When you perform a diagnostic procedure and go on to perform a definitive procedure, the diagnostic is considered the approach and therefore part of the definitive. Also when CCI states no modifier allowed then there are no exceptions.