DecisionHealth, DecisionHealth - 2011 Issue 8 (August)

Benchmark of the Week: Modifier 59 denials, 2005 vs. 2009

Codes with modifier 59 (distinct procedural service) attached represent a major source of lost non-E/M revenue. This chart shows denial rates for high-utilization codes with modifier 59 attached in 2009 and compares them to their rates from 2005. NOTE: Codes with low utilization and/or low value (as measured by annual reimbursement paid out by Medicare) were excluded from analysis.

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