Proper Use of Modifier 59

Submitted by Matthew.Gregor… on Mon, 11/04/2019 - 07:41
Title
Proper Use of Modifier 59
Date

For Procedure-to-Procedure (PTP) edits that have a Correct Coding Modifier Indicator (CCMI) of "0," the codes should never be reported together by the same provider for the same beneficiary on the same date of service. If they are reported on the same date of service, the column one code is eligible for payment and the column two code is denied. Refer to MLN Matters® Special Edition Article SE1418 (PDF)  for more information.