Wiki Using Modifier 59 w/ add-on codes?

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L4uniki

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I have just started going through denied claims in a new position. I am seeing modifier 59 used with 64636 as add-on 2 line items with CPT 64635. I have never used this modifier for this procedure, have I missed something, or is this the reason these claims are denying? Thanks, LB
 
You are correct, modifier 59 should not be used in this scenario. 64635 is for the first facet joint, and 64636 is for each additional joint. There should not be a CCI edit or inclusion issue that would warrant the use of modifier 59 to distinguish between the procedures.
 
The only case we have found the need to bill modifier 59 for 64636 is when a 3 level RFA is performed and the carrier requires the second line to be separated.
64635
64636
64636-59

Normally we would bill as
64635
64636x2
 
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