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IDEAS THAT WORK
MODIFIER -59
New Shoulder Arthroscopy Reporting Rules
SHOULDER SCOPES CMS has revised the correct reporting of shoulder arthroscopies.
Don't append modifier -59 to an edit code pair describing 2 shoulder joint procedures — unless you perform the procedure considered the component of the primary procedure on the opposite shoulder, according to new shoulder reporting guidelines from CMS.
This doesn't mean that you can report only 1 shoulder code for all cases. The new guidelines state if there are
bundling issues, modifier -59
wouldn't be appropriate unless it's to report the procedure performed on the contralateral shoulder. If there are no bundling issues, modifier -59 is not applicable and procedures are reported to
