Author Topic: 59 modifier  (Read 1217 times)

amelero

  • Newbie
  • *
  • Posts: 4
59 modifier
« on: October 10, 2010, 06:12:51 PM »
If the 59 modifier is used when using more than one treatment modality in the same day, does the insurance count that as an extra visit?

I believe that when a 59 modifier is used for more than one eval (office visit) in the same day (one for each diagnosis), it can count as more than one patient visit. But i was wondering if it is counted that way when using it only for unbundling treatment modalities.
Thanks

Adrian

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4705
    • Solutions Medical Billing
Re: 59 modifier
« Reply #1 on: October 10, 2010, 09:01:10 PM »
I've never seen the 59 modifier cause a visit to be counted as an extra visit.
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Anand

  • Jr. Member
  • **
  • Posts: 62
Re: 59 modifier
« Reply #2 on: October 11, 2010, 08:38:27 AM »
If the 59 modifier is used when using more than one treatment modality in the same day, does the insurance count that as an extra visit?

I believe that when a 59 modifier is used for more than one eval (office visit) in the same day (one for each diagnosis), it can count as more than one patient visit. But i was wondering if it is counted that way when using it only for unbundling treatment modalities.
Thanks

Adrian

If i got your question right, i never seen 59 modifier used in office visit( Evaluation & Mgmt code). Especially this modifier is bit tricky, if you just google, you should get good answers.. of when & how 59 mod can be used. It is bascially used for distinct procedures done on the same day...

cdistefano

  • Newbie
  • *
  • Posts: 1
Re: 59 modifier
« Reply #3 on: October 11, 2010, 03:40:32 PM »
The -59 modifier is used to identify procedures/services, other than E/M services, that are not usually reported together, but are appropriate under the circumstances.  Modifier -59 should NOT be appended to an E/M service.