DecisionHealth, DecisionHealth - 2017 Issue 2 (February)
Check your specialty’s denials with modifier 59 — by number as well as rate
Your chance of a denied claim goes up when you bill codes with modifier 59 (Distinct procedural service). In 2015, the most recent year available for Medicare claims data, claims with modifier 59 had a 19% denial rate versus a 16% denial rate without it. But that average fluctuates depending on specialty — and each of those specialties has its own highly denied codes when billed with 59.
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