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Topic: Review modifier -59 and T modifiers used for podiatry coding
Ambulatory Surgery Reimbursement Update, September 9, 2008
Sometimes, those multiple procedures are lost in coding because the coders use the wrong modifier. That may mean you are leaving money on the table, so follow the rules for T modifiers and modifier -59.
Coders for podiatry often misuse modifier -59 and T modifiers and this leads to incorrect coding. Any time a physician operates on a toe, the physician uses T modifiers to identify the toe(s) on which he or she operated. Use modifier –TA to refer to the big toe and then identify the subsequent toes using modifiers -T1, -T2, -T3, and -T4, Weil says.
Coders should use these modifiers only when a podiatrist is operating specifically on toes. If he or she operates on anything behind the toes, a coder would simply indicate whether the procedure was performed on the right side or the left side, Weil says.
“[Modifier -59] is the one that gets people into the most trouble,” says Michael Warshaw, DPM, CPC, FACFAOM, healthcare consultant and practicing podiatrist in Ravenna, OH. “According to the government, modifier -59 is used inappropriately 40% of the time.”
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