Health Information Management

Pay-per-view: Five myths about correct use of modifier -59 busted

APCs Insider, September 17, 2010

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Correct use of modifier -59 (distinct procedural service) can confuse novice and veteran coders alike, in part because so many commonly held beliefs about modifier -59 just aren’t true.

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.”

Continue reading “Five myths about correct use of modifier -59 busted” on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the September issue.



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