tci Part B Insider - 2014 Issue 30

Modifiers: CMS Debuts 4 New Modifiers to Substitute for -59

Medicare will still accept modifier 59, but use the new modifiers instead when applicable. Popularity can be a great thing—unless the OIG is watching. That’s when you don’t want to run with the crowd. Such has been the case with modifier 59, which CMS describes as “the most widely used HCPCS modifier,” and intends to stop that by introducing four modifiers to take its place in specific circumstances. As most coders are aware, modifier 59 (Distinct procedural service) can separate CCI edits, but it is not meant to be utilized solely for that reason...

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