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CCI column 1 & 2 question: which column gets the modifier -59

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thelakeshow2k:
is it standard that we should add -59 to one of the columns?  thanks.

PMRNC:

--- Quote ---is it standard that we should add -59 to one of the columns?  thanks.
--- End quote ---

For what??

thelakeshow2k:
...to bill both codes on the same visit. 

example: medicare will not not pay cpt 11100 if billed with 17000 on the same visit unless modifier -59 is listed with 11100. 

Michele:
It is never 'standard' to add a modifier.  The modifier should be added if the provider or the coder believes it is required to correctly indicate the services that were performed.  If you are billing and you are aware that the code is not covered without the modifier it would be a good idea to bring it to the attention of the provider or coder.  They may not have realized they need to consider the use of the modifier, but they need to decide if it is appropriate for the services that were provided.

Michele

oneround:
Good answer Michele

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