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Home / Products / All Trainings / Modifier 59: Proven Strategies to Boost Pay &
Halt Denials
Home / Coding / Modifier 59: Proven Strategies to Boost Pay & Halt Denials
MODIFIER 59: PROVEN STRATEGIES TO BOOST PAY & HALT DENIALS
Date: Wednesday, July 19, 2023 1:00PM EST Length: 60 Minutes Expert: Dreama
Sloan-Kelly, MD, CCS, CPC CEU: 1.0
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Using modifier 59 to sidestep bundling denials certainly boosts your
reimbursement, but it has also driven payers to add these claims to their active
watch lists.
Insurers are just waiting for you to make a mistake — and there are plenty of
opportunities to do so. Muddying the waters is the fact that you can also choose
the X modifiers when your provider performs more than one procedure—and you must
wade through reams of NCCI edits before pinpointing the right option. Append
modifier 59 in error, and you’ll not only face denied claims, but you’ll also
expose your practice to the fines and penalties that follow.
How steep are the penalties? Think $10,000 PER line item that you submit on your
claim. That’s enough to sink any medical practice, no matter how well its other
operations run. Your best defense is to shore up your modifier 59 use
immediately. That means using it exclusively when it’s the ONLY modifier left
after ruling out all others, mastering the NCCI pairs, and knowing which line
item gets modifier 59 and which doesn’t.
If this sounds like a lot to master, that’s because it is. But you don’t have to
go it alone.
Nationally recognized physician, coder, and healthcare consultant Dreama
Sloan-Kelly, MD, CCS, CPC, is here to help. During her one-hour online training
session at 1 pm ET on Wednesday, July 19th, Dr. Sloan-Kelly will walk you
through the nuances of correctly utilizing modifier 59. She’ll help you better
identify distinct procedural services to help you get reimbursed more of what
you are due.
Here are just a few of the modifier 59 strategies Dr. Sloan-Kelly will share
with you during her exclusive online training event:
* Differentiate modifier 51 and the X modifiers from modifier 59
* Identify how insurers define “distinct” to cut claim denials
* Audit-proof your documentation terminology to justify modifier 59 usage
* Slash denials, more easily incorporate 2023 NCCI edits into your coding
practices
* Cut confusion by mastering the difference between modifiers 59 and 25
* Strategically apply modifiers in the correct order to maximize pay up
* Determine which services are bundled into the main procedure and which
are separate
* Pin down how to overturn incorrectly denied modifier 59 claims
* Improve acceptance odds by mastering when to use the “modifier of last
resort”
* And much, much more…
IMPORTANT: Modifier 59 misuse is so much more than a Medicare issue. Nearly
every payer is looking for ways to save money, and one key method is to boost
denials for modifier 59 claims which typically reimburse at a higher rate in
higher frequencies. Payment reviews of this modifier are happening across the
board, and you don’t want to be a statistic.
Don’t risk seeing your claims denied—or worse, being accused of modifier
fraud—because you didn’t take the time to master this complex modifier. Sign up
today for Dr. Sloan-Kelly’s exclusive training event so you can keep your claims
processing smoothly and successfully. Space is limited – register right away.
Order Now
MEET YOUR EXPERT
DREAMA SLOAN-KELLY
MD, CCS, CPCCEO OF KELLY, SLOAN AND ASSOCIATES, LLC
Dreama has over 14 years of experience in the medical field. A graduate of
Wellesley College and Tufts University School of Medicine she has a varied
background including clinical, billing, and coding. As CEO of Dr. Sloan-Kelly
Consulting, Dreama speaks at various seminars, imparting her knowledge in an
upbeat, matter of fact, manner.
Her goal is to provide attendees with only pertinent information to minimize the
nonsense, and make sure everyone has fun at the same time. Dreama works with
practices one on one, through coding consulting. She offers in-services seminars
that can be held on or off-site. Dreama has learned in most seminars you spend a
whole day only getting 20% of what you need, and 80% you leave – she has made it
her goal to carve out the 20% that you need and giving you the take home message
that will help you and your practice.
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* RESOLVE INFORMED CONSENT VIOLATIONS TO AVOID LEGAL NIGHTMARES
from $277.00
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* SIMPLIFY DIFFICULT CONVERSATIONS W/PATIENTS, BOOST PAY UP
from $277.00
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* OVERTURN PAYER DENIALS DUE TO 2023 NCCI EDITS & GET PAID MORE
from $277.00
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