Use of Modifier 59 and Denials Management
A modifier should never be applied to increase reimbursement or to receive payment for an operation that would otherwise be packaged with another code. Modifier 59 identifies a distinct procedural service and is used to distinguish solutions and processes that are not generally recorded in the same report. It should be used, when coding for a particular session, a different treatment or surgery, another site or organ system, a separate incision/excision, a separate lesion (non-contiguous lesions in different anatomic parts of the same organ), or separate damage. Modifier 59 should only be used on Evaluation and Management Codes when no other modifier is applicable.