LeapZipBlog: cioccolatocouture's blog: 59 Modifier for PT and Chiropractic

59 Modifier for PT and Chiropractic

July 19, 2019 by cioccolatocouture  

Utilizing the 59 modifier can be complicated for physical therapists and chiropractors.  When used correctly it will help to maximize your revenue. Be careful to use it properly because the 59 modifier is the most abused modifier and that can cause havoc in the form of denials, recoupment, and penalties.

 

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Revenue cycle management

 

Modifier 59 has confused many providers and it is easy to understand why.  The modifier allows the provider to charge for two separate services that are not separately payable according to the National Correct Coding Initiative (NCCI).

Modifier 59 should not be used as a means for payment for services that would have been bundled. Do not use it routinely with evaluation codes because that might cause suspicion from the payers.  Make sure your documentation supports the usage of the 59 modifier or you might find yourself refunding large amounts of money to the payer.