Becker's ASC

2015 CMS modifier -59 reporting change: 4 new modifiers added

The Centers for Medicare and Medicaid Services acknowledges that there are code combinations that may warrant an exception in reporting based on clinical documentation. Coders tend to err on the side ...
Becker's ASC

3 Critical Mistakes Made When Reporting Modifier -59

3. Over-utilization of -59. Do not use -59 to bypass the edits when a procedure is truly integral to the main procedure. Remember, simply because the Medicare edits may allow for a modifier doesn’t ...
The American Journal of Managed Care

Avoiding Risk Using New X Modifiers for Medicare Reimbursement

On January 1, 2015, the Centers for Medicare & Medicaid Service (CMS) introduced 4 Healthcare Common Procedure Coding System modifiers, known collectively as the - X(EPSU) modifiers, as a subset of ...
Healio

Modifying the modifier

In addition to the creation of several new CPT codes for 2015, one CPT change is not about a new code but rather an old modifier. Modifier –59 is used when we want to communicate with the insurance ...
Fierce Healthcare

Healthcare CFO pleads guilty to fraud; CMS creates new modifiers to refine '59';

> Daniel K. Lane, Jr., vice president and chief financial officer for Compass Healthcare, Inc., pleaded guilty to conspiracy to commit healthcare fraud for filing fraudulent claims with government and ...