Modifier -59: Issues and Solutions

Description

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