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Modifer 59 usage

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horizonmb:
Hello,
I am new to Physical therapy billing and need some assistance with it. If a PT does Eval(97163) and does 1 unit each of 97110, 97112, 97116, and 97535 all on same day to a patient. Should I add modifier 59  to 97112, 97116, and 97535 ( total of 3 times once for each CPT) or should I add modifier 59 to 97110 also ( making it a total of 4 times) once for each CPT except evaluation.
Thanks!

Michele:
Be careful when adding modifiers.  As a biller we tend to add a modifier to "get a service paid".  You must make sure that the patient's notes support the use of the modifier.  With that being said, the 97110 wouldn't need a modifier as it's allowed separate from the eval.  I don't believe the 97112 requires any modifier either.  But the 97535 & 97116 may need the 59 modifier if the notes warrant it.

bsmith10:
Modifier 59 is attached to 97140 if your billing out an evaluation code - this applies to BCBS some commercial and Medicare will want the 59 when billing out 97530. I am in Michigan so BCBS and your commercial may be different

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