Health Information Management

Five myths about correct use of modifier -59 busted

Briefings on APCs, September 1, 2010

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On the surface, modifier -59 seems like a great solution to ensure denied codes are paid. “Unfortunately, that little magic modifier, which seems so great, can turn against you if it’s not properly used,” says Peggy Blue, MPH, CPC, CCSP, lead instructor for HCPro’s Medicare Boot Camp®–Professional Services Version. “Improper use of modifier -59 can be considered abusive, or it can even be considered fraudulent billing.”

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