Modifier -59 : Head off Audits, Reduce Denials, and Get Paid More for Your Multiple Procedures: 2016 Expert Report

Consistent misuse and abuse of modifier -59 has put it on the Office of the Inspector General's active radar. Meaning they are just waiting for you to slip up.To make matters worse, -59 sub modifiers (-XE, -XS, -XP, -XU) and varying carrier guidelines, make it even more difficult to get it right. In fact, CMS Transmittal 1422 projected error rates for modifier -59 at $320 million in physician claims and $450 million in facility claims.Considering the size of these projected overpayments, you can rest assured that CMS is sitting up and paying close attention and will be working hard to recoup this reimbursement.So, what does this mean to you?If you are found to be using modifier -59 erroneously, the reimbursements you received for those services will be taken back. And if that leads to a full scale audit of your modifier -59 claims, you could also have to pay fines for the overall behavior on claims going back years. Remember, Medicare fines are $10,000 for each occurrence. That means each time you billed modifier -59 on the line of a claim incorrectly you would have to pay a $10,000 fine.Your only defense is to take action. You need to get a firm handle on complying with modifier -59 guidelines - including the four new sub-modifiers -XE, XS, XP and XU, and the special report, Modifier -59: Misused and Misunderstood is the answer. This report will give you everything you need to ensure you are filing this complex claims correctly.You can trust the information in this special report because it was prepared and reviewed for accuracy by three leading coding experts: Jill M. Young, CPC, CEDC, CIMC, Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, and Maxine Lewis, CMM, CPC, CPC-I, CCS-P.