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Printed Date: 9/22/2015
When another already established modifier is appropriate, it should be used rather than CPT modifier 59. CPT modifier 59 is an important National Correct Coding Initiative (NCCI) associated modifier that is often used incorrectly, and it should only be used if no more descriptive modifier is available or when its use best explains the circumstances.
For the NCCI, the primary purpose of CPT modifier 59 is to indicate that two or more procedures are performed at different anatomic sites or during different patient encounters. It should only be used if no other modifier more appropriately describes the relationships of the two or more procedure codes.
NCCI edits define when two procedure HCPCS/CPT codes may not be reported together except under special circumstances.
If an edit allows use of NCCI-associated modifiers, the two procedure codes may be reported together if the two procedures are performed at:
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Last Updated: 02/07/2018