Application of Modifier 59 Changing on July 1st

June 24, 2019
Rick Gawenda

For dates of service on and after July 1, 2019, the Centers for Medicare and Medicaid Services (CMS), as well as UnitedHealthcare (UHC), is changing which CPT code Modifier 59 must be appended to on the claim form in order for both the Column 1 and Column 2 CPT codes to be paid when provided on the same date of service. If you missed my webinar last week on NCCI edits and Modifier 59, click HERE to see the complete webinar description, objectives and to order the recorded version with handouts and Gawenda Seminars & Consulting NCCI edit reference sheet.

Currently, the multi-carrier system (MCS) claims system processing logic for modifier 59, XE, XP, XS and XU be appended to the

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  1. So we leave modifier 59 on the claim and add an x modifier as well? Or we just leave modifier 59 and it now doesn’t matter which cpt code it is attached to?

    Thank You