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How to use modifier 59 in a podiatrist setting

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Author Topic: PODIATRIST BILLING  (Read 165 times)

isabelreyna

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PODIATRIST BILLING
« on: April 10, 2018, 10:00:55 PM »
 ??? I just been putting 59 on all my billing with more then one procedure and an office visit. Now I am question myself, if i been doing this incorrect.
« Last Edit: April 10, 2018, 10:03:39 PM by isabelreyna »

Michele

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Re: PODIATRIST BILLING
« Reply #1 on: April 11, 2018, 10:33:30 AM »
I'm assuming you are the biller, not a coder.  Modifiers should only be added by either the dr or someone with access to the patient's chart.  The way that your question is worded makes it appear that you are simply throwing on the 59 modifier in hopes of all codes being allowed and that is not good.  The notes must justify the modifier.  Often times billers will (with good intentions) do whatever they think is needed to get the codes paid.  But you have to be careful because if the patient's notes don't justify the modifier that is considered fraud.  You should verify with the provider that the procedures they are doing are all independent from one another or ask them if the procedures warrant the 59 modifier. 
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PMRNC

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Re: PODIATRIST BILLING
« Reply #2 on: April 11, 2018, 02:36:52 PM »
I agree with Michele, if you already "feel" it's not right, it's probably NOT right. Routinely adding a modiier on your own is probably dangerous business if you are not a certified coder and not looking at the documentation you are billing. Even if you are a certified coder, the liability is the same, your putting yourself at risk by doing something routinely as you describe. It's probably UNLIKELY that every visit your appending the modifier is warranted so you really want to take a look at what your looking at in coding. Cover yourself.



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EDREIBELBIS

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Re: PODIATRIST BILLING
« Reply #3 on: May 07, 2018, 01:49:32 PM »
I agree with the previous responses, I work for a podiatry office and it is very rare that we utilize the 59 modifier in our billing.

ErickVA65

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Re: PODIATRIST BILLING
« Reply #4 on: May 15, 2018, 08:49:11 AM »
I agree with Michele. I have done with 59 modifiers. Best way is to follow the LCD and NCCI guidelines. It will tell you which you can use.

Erick