Modifier -59: Issues and Solutions

Product Id : HE61
Instructor : Jan Rasmussen
Mar 27, 2019 1:00 PM ET | 12:00 PM CT | 10:00 AM PT | 60 Minutes

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Overview

Modifier -59 has a long history of misuse which continues today because many billers still don’t fully understand modifiers or when to use them. The purpose of modifiers is to accurately describe a procedure and should be added to CPT® codes with caution.

Modifier -59 should never be used to increase reimbursement or to get paid for a procedure that will otherwise be bundled with another code. That’s technically and ethically wrong. Modifier can be tricky and Modifier -59 is trickiest among them all! But when providers inappropriately use them and abuse them, it inevitably leads to claim denials.

Modifier -59 has been on the OIG’s (Office of the Inspector General) radar for some time and is now on their radar again. Misunderstanding of appropriate use of Modifier -59 and the X modifiers can be costly for your practice. So, getting a better understanding of this modifier does make sense.

Join us for this webinar with expert speaker Janice Rasmussen to get a deeper understanding of Modifier -59 and X modifiers; when it should be used; and how to avoid costly mistakes while doing so.

Session Highlights:

  • Correct use of Modifier -59 and X modifiers
  • Understand the CCI (Correct Coding Initiative) guidelines and edit system
  • “Separate procedures” and appropriate use of Modifier -59 on those services
  • When Modifier -59 should never be reported
  • Best practices to reduce denials and audits
  • How to gain confidence in correct surgical coding for multiple procedures
  • Documentation techniques for providers to support the use of Modifier -59 or the X modifiers

Who Will Benefit:

  • Providers
  • Billers
  • Coders
  • Office managers
  • Denial resolution teams
Speaker Profile:

Jan Rasmussen - PCS, ACS-GI, ACS-OB is a healthcare consultant with more than 30 years of experience in physician billing, reimbursement and compliance. She is a former board member of the American Academy of Professional Coders (AAPC). As a member of the AAPC, Rasmussen previously served on the AAPC Advisory Board as the liaison to the American Medical Association (AMA).

Jan was a board member and Regional Governor for ACMCS. She has been a guest speaker for the AAPC annual conference and previously contributed to the development of AAPC's independent study and university education programs.


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