Modifier 59 & X{EPSU}

Good afternoon-

Quick question. Is there a reduction in reimbursement when either the modifier 59 or one of the X{EPSU} modifiers are appended like a bilateral or multiple procedure reduction happens?

Thanks

Donna

Donna M. Beaulieu, C-CDI, CPMA, CPC-I, CRC, CPC, CEMC, CIMC, CEDC, CFPC, CCP-P, CRP
Certified Green Belt, Lean Six Sigma
Assistant Director, Patient Financial Services
Emory Healthcare


Comments

  • edited May 2017
    Only if both codes have an indicator of 2 in the mult proc column on the RVU file would the 50% reduction apply.


  • Good morning,

    Question: It does not pertain to coding but perhaps someone may be able to answer.

    What is the filing limitation for Medicare as the secondary payer? Is it 12 months from the date of service or from the time the primary pays?

    Thanks

    Pat
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