When is it appropriate to use modifier 59?


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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