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Question:
When is it appropriate to use modifier 59?
Answer:
If a diagnostic procedure precedes a surgical or non-surgical therapeutic procedure and is the basis on which the decision to perform the surgical or non-surgical therapeutic procedure is made, the two procedures may be reported with modifier 59 appended to the column two HCPCS/CPT® code under appropriate circumstances. However, if the diagnostic procedure is an inherent component of the surgical or non-surgical therapeutic procedure, it cannot be reported separately.
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CPT® copyright 2023 American Medical Association (AMA). All rights reserved.
Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
CPT is a registered trademark of the American Medical Association.
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