How should modifier -59 be used under NCCI?
Modifier -59 is used to indicate a distinct procedural service. To appropriately report this modifier, append modifier -59 to the column 2 code to indicate that the procedure or service was independent from other services performed on the same day. The addition of this modifier indicates to the Medicare carriers or fiscal intermediaries that the procedure or service represents a distinct procedure or service from others billed on the same date of service. In other words, this may represent a different session, different anatomical site or organ system, separate incision/excision, different lesion, or different injury or area of injury (in extensive injuries). When used with a NCCI/CCI edit, modifier -59 indicates that the procedures are different surgeries when performed at different operative areas or at different patient encounters. If none of the anatomical modifiers can be used appropriately to describe the different site, then the modifier -59 can be attached to indicate the separ
Related Questions
- How do I correct a CO-4 denial (the procedure code is inconsistent with the modifier used, or a required modifier is missing)? How do I determine what the cause is?
- Should modifier 24 be used to report a diagnostic test in the global surgery period?
- Why is there a new modifier, KD, for drugs used in an implanted pump?
