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 […]
Here is the relevant text in the Change: 3.14 – Clinical Review Judgment (CRJ) (Rev. 338, Issued: 05-14-10, Effective: 04-23-10, Implementation: 06-15-10) A. Contractors to Which This Section Applies This section applies to ACs, MACs, CERT, RACs, PSCs, and ZPICs, as indicated below. B. General The CRJ involves two steps: (1) the synthesis of all […]