Wiki Modifier 59

[sluke9]

I have a provider that is doing a nebulizer demo. The billing company says that modifier 59 needs to be added so that it won't get bundled into the E/M. By the definition of 59 it doesn't seem that it would be appropriate to add to this service. Has anyone ever heard of this or any thoughts if this is appropriate?

 

[ehanna]

I have a provider that is doing a nebulizer demo. The billing company says that modifier 59 needs to be added so that it won't get bundled into the E/M. By the definition of 59 it doesn't seem that it would be appropriate to add to this service. Has anyone ever heard of this or any thoughts if this is appropriate?

Is he giving a treatment while he is showing the patient how the machine and treatments work? If so I would put a -25 modifier on the E&M level. If he is teaching only then it should be included in the level.

I hope this helps