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Jan 16, 2018 · But at the same time, it is a two-edged sword, the modifier 59 is exceptionally dangerous when used incorrectly and care is not applied, just like a doctor would find for their patient when using prednisone. Modifier 59 is the universal unbundling modifier.
Modifier 59 is an important NCCI PTP-associated modifier that physicians and providers often use incorrectly. This fact sheet will help you use this modifier correctly. Definition of Modifiers 59, XE, XP, XS, & XU
Dec 13, 2018 · Modifier 59 Distinct procedural service is an “unbundling modifier.” When properly applied , it allows you to separately report—and to be reimbursed for—two or more procedures that normally would not be billed or paid independently during the same provider/patient encounter.
Jul 1, 2020 · When NCCI bundles two codes with a status indicator of “1,” you may be able to break the bundle using a modifier, such as modifier 59 Distinct procedural service. How do you decide when you can — and more importantly, can’t — use modifier 59? Even veteran coders can fall into the modifier 59 trap.
This fact sheet educates physicians and other providers on proper use of modifiers 59 and –X{EPSU} and gives information on: Definition of modifiers 59, XE, XP, XS, and XU. Appropriate and inappropriate use of these modifiers. Examples of appropriate and inappropriate use.
Jul 2, 2024 · Modifier 59 is referred to by CMS as the modifier of last resort. It is often used when modifier 51 is the more accurate modifier. This quick reference sheet explains when, why and how to use it.
Publication Description: Learn how to correctly use modifiers 59, XE, XP, XS, and XU.
What is Modifier 59? Modifier 59 is used to define a “Distinct Procedural Service.” These are procedures and services performed by a healthcare provider that are not typically reported together, but are appropriate and separately billable given the circumstances.
Modifier 59 or the XS modifier may be used appropriately for procedures performed on different anatomic sites during the same encounter when the procedures are performed on different organs or on different, noncontiguous lesions in the same organ.
The 59 modifier, which is used to indicate a "distinct procedural service," is one of the most widely misused modifiers. Strategic insights, perspectives and industry trends for healthcare executives.
