Wiki Use of modifier 59

[Kellyj0h]

I am working on billing for a urologist. When he bills a 52000, 51741, and 51798 all together, do I need to add a 59 modifier on two of the charges?

 

[MnTwins29]

No, you don't

I ran the codes through our system checking for CCI edits - all three may be billed together without the modifier -59. You may have been confused by the "separate procedure" description on 52000. Since the EMG or post-voiding measurement described by the other are separate and the cysto is not part of them, there is no need for -59.

 

[Kellyj0h]

Modifier 59

So do the CCI edits only show the codes that either require modifiers, or that are not allowed to be billed together with modifiers? Their spreadsheet is confusing. When i enter these codes, it doesn't show them listed together to let me know about modifiers.

 

[MnTwins29]

So do the CCI edits only show the codes that either require modifiers, or that are not allowed to be billed together with modifiers? Their spreadsheet is confusing. When i enter these codes, it doesn't show them listed together to let me know about modifiers.

Our editor shows both - either that you can't bill the codes together or that you can, but a modifier would be needed. I got none of those messages with any combination of your three codes.

 

[garzoyan]

modifier

Hello

i work convenient clininc and we are billing to Medicaid. Our porviders are Np or PA. To submit claims to Medicaid i need a modifier to show that the services are rendered by NP
Does anybody knows about modifiers?? Please advise.