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September 2016

Coding Corner: Modifier 59

Coding Corner: Modifier 59

Matthew D. Hepler, MD
Coding Committee Chair

Introduction

There has been a significant increase in the number, breadth and depth of spine procedures performed in the United States in the last two decades and, concomitant with these trends, an increasingly complex coding system for documentation and billing. This complexity combined with enhanced payor scrutiny has resulted in more audit activity, more claim reviews and denials, and more administrative burden.