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Modifiers

Modifiers

Solve Your 5 Biggest Modifier 59 Problems by Focusing on ‘Separate’

If you’re using Modifier 59 to get paid for multiple procedures, auditors are watching you. Modifier 59 has been on the OIG’s (Office of the Inspector General) radar for a while now, and because of consistent misuse and abuse, it will likely stay that way. Modifier 59 allows you to unbundle — separately report and […]
Published Date: July 29, 2019
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Modifier 51 over 59

When To Use Modifier 51 over 59

When would I use modifier 51 instead of modifier 59? If you would have asked me that question 10 years ago, I would have told you not to use a 51 modifier because it causes bundling reimbursement. But 51 is now in your CPT book for when you are doing skin or endoscopic procedures. There […]
Published Date: September 25, 2017
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Infusion Administration

Recognize Infusion Administration Types to Ensure Proper Payment

Coding infusions is far from run-of-the-mill, and if you don’t get it right, you’ll likely see reduced — if not denied — claims. One of the key concepts when reporting this service is understanding the type of infusion you’re providing. Get it right, and your claim sails through, but get it wrong, and you’ll be […]
Published Date: July 18, 2017
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Modifier Choice

Modifier Choice Key in Boosting Payments for Bilateral Procedures

If you report bilateral procedures — and most practices do — how you tell your payers that you performed the same services on both sides of the body depends greatly on the payer itself. But there are some general tools and strategies you can follow that will point you in the right direction, and help […]
Published Date: January 17, 2017
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X Modifiers Over Modifier 59

When to Use X Modifiers Over Modifier 59

Consistent misuse and abuse of modifier 59 has put it on the Office of the Inspector General’s active radar. Meaning they are just waiting for you to slip up. To make matters worse, modifier 59 sub-modifiers (XE, XS, XP, XU) and varying carrier guidelines, make it even more difficult to get it right. In fact, […]
Published Date: December 20, 2016
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