Get started with auditing modifier -59
Health Care Auditing Strategies, February 1, 2006
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When coders need to indicate that a provider performed two distinct services for the same person on the same day, they use modifier -59.
That explanation makes the concept sound easy, but complying with the nuances of modifier -59 is difficult. Providers must account for a huge spectrum of variables when determining whether the modifier is appropriate.
What's more, modifier -59 figures prominently on the OIG's radar. The OIG released a comprehensive audit of the use of modifier -59 in Dec- ember 2005. As a result, carriers and FIs will be conducting pre- and postpayment reviews, according Stacie L. Buck, RHIA, LHRM, vice president of Southeast Radiology Management in Stuart, FL.
This is an excerpt from a member only article. To read the article in its entirety, please login.
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