How Best to Use Modifier 59

[摘要] The National Correct Coding Initiative (NCCI) maintains a list of procedures that are “bundled” and therefore cannot be billed at the same date and time. In some circumstances the two procedures can never be paid with one another under any circumstance, whereas in other cases the two procedures can be paid together if certain unique circumstances exist. Modifiers are used to help communicate these unique circumstances and are necessary to bypass the NCCI edits. Commonly used modifiers to communicate these unique circumstances include Modifier 58 (staged procedure within the global period), Modifier 59 (distinct procedural service), Modifier 76 (repeat procedure), Modifier 78 (subsequent or related procedure/ service within a global, unplanned return to the operating room), and Modifier 79 (unrelated procedure/ service by the same provider within the global period).

[学科分类] 基础医学