Most coding professionals have heard modifier -59 (distinct procedural service) referred to as a modifier of last resort and to be cautious in using this modifier.
Conducting pre-billing audits can be challenging, but when done correctly, it can save organizations from spending time recoding and rebilling claims that payers deny. These audits can be conducted on the front end, in both inpatient and outpatient settings, once records have been coded.
In an effort to accommodate the latest advances in technology and make the code set easier to modify for future technological changes, the AMA extensively overhauled codes for reporting drug testing in the 2015 CPT® Manual.
Lately I've received a lot of questions from hospitals about how to determine when and if it's appropriate to report an E/M visit code on the same date of service as a scheduled procedure.
This week’s updates include a fact sheet about the ACO Investment Model and several reports from the OIG. Click the link above to read more about this week’s updates.
