59 Modifier Creation

EXTREME CAUTION: These rules fire for ALL visits when "Checkout Patient" is clicked based on the Insurance Type (Professional or Institution). Some Billing requires the use of the 59 modifier to be attached when codes are billed together, this rule will ensure that the modifier will automatically be added.

You will be able to add additional 59 rules inside the Billing tab -> Manage:

Next step will be to go to the 59 Rules tab:

There will be a Create Button on the upper Right hand side on the screen:

You can add a name to the rule and select if this is for Professional Claims or Institutional Claims

Once the rule is created, you will be able to start adding the CPT codes to the rule by click the Add (+) button in the middle right of the screen:
In the pop-up, select the first code and if a Modifier is needed:

Add the second code and if the Modifier is needed:

Once created, you will be able to view and Edit the rule if needed: