Question

where should we insert coding after it is completed

Answer 1

Answer:

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Answer 2

Answer:

A modifier should never be used just to get higher reimbursement or to get paid for a procedure that will otherwise be bundled with another code.

But modifiers can be tricky. Many times providers inappropriately use them, an abuse which inevitably leads to claim denials. For our guide on the 3 most commonly misused modifiers, click here.

THIS IS PART OF THE MODIFIER SERIES, THE ARTICLES INCLUDE:

Modifers 59, 25, and 91

Modifier 59

Modifier 25

Modifier 26

In this article, though, we’ll focus on the trickiest of them all, modifier 59.

The definition of the 59 modifier per the CPT manual is as follows:

Modifier 59: “Distinct Procedural Service” – Under certain circumstances, the physician may need to indicate that a procedure or service was distinct or independent from other services performed on the same day. Modifier 59 is used to identify procedures/services that are not normally reported together, but are appropriate under the circumstances. This may represent a different session or patient encounter, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same physician. However, when another already established modifier is appropriate, it should be used rather than modifier 59. Only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used.