Wiki Modifier -59

[Summer]

Hello,

Verifying, if a modifier -59 is placed on a cardic cath and billed with a stent placement on the same day, the heart cath will be reimbursed at 50% of the fee schedule and the stent placement will be paid at full fee - correct?

Thank you in advance.
Summer

 

[Twixle2002]

Hi Summer,

The 51 modifier is automatically reduced by 50%. Depending on the payer a 59 could reduce the payment by 50% as well.. Some payers don't decrease because of a 59. We ususally have to send in documentation and they make the determination from there.