tci Part B Insider - 2014 Issue 21

Modifiers: Modifier 59 Won't Apply to All 'Separate Site' Examples, New CMS Advice Says

Treating ‘contiguous structures’ is an exception to this well-known rule. Modifier 59 is used so ubiquitously in Part B practices that many coders think they know all of the facts about it—but you could probably still benefit from some education on the “distinct procedural service” indicator. CMS wrote its most useful modifier 59 tips in new MLN Matters article SE1418, issued last week, so every coder can get all of the facts on its appropriate use. Background: If you need a modifier to override CCI edits that bundle two services or procedures that were performed on...

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