Bill comprehensive and component x-rays using modifier -59
APCs Weekly Monitor, January 12, 2007
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Bill comprehensive and component x-rays using modifier -59
QUESTION: When a patient arrives to the ED with a cervical collar, or emergency medical services have strapped the patient to a back-board, emergency physicians will order a lateral spine x-ray prior to removing the collar or back-board. This prevents exacerbation of trauma or spinal cord injury. After the lateral x-ray is cleared for acute fracture or injury, the physician completes the exam, and may then order complete spine films (including anteroposterior and lateral).
Does the initial lateral film constitute a separate and distinct service? If so, would this justify appending modifier -59 and allow us to bill both the comprehensive and component radiology exams?
ANSWER: In short, yes. The physician specifically ordered the lateral x-ray to diagnose the patient for the purpose of treatment, which in this case is optimal removal of the back-board or collar.
After that step, as well as a more extensive examination, the physician ordered a separate type of x-ray for more definitive diagnoses. The x-rays are separated by purpose and by timing. For these reasons, you can report the second exam using modifier -59.
Want to receive articles like this one in your inbox? Subscribe to APCs Weekly Monitor!
Related Products
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- QA:Coding multiple initial infusions
- News and briefs: Oklahoma Osteopathic Association against residency bill change
- HIPAA Q&A: Level of encryption needed for email
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- What does case-mix index mean to you?
- ED-to-inpatient transfers are flawed with safety gaps
- Joint Commission Center announces handoff communication solutions
- Inside best practice: Reduce patient falls with a stoplight
- Identify modifiable risk factors to prevent patient falls
- Searched