|May 2006 · Vol. 18, No. 5
Coding a new patient’s 2 visits in 1 dayMelanie
RN, CPC-OGS, MA
Independent coding and documentation consultant; former program manager, Department of Coding and Nomenclature, American, College of Obstetricians, and Gynecologists
Q One of our doctors saw a new patient in labor and delivery, and then she was seen in our office for a more extensive exam and ultrasound on the same day, but by a different doctor. Normally I would bill both with a -59 modifier (Distinct procedural service) assigned to an evaluation-and-management (E/M) code, but I was recently told that the -59 modifier should not be assigned to an E/M code. How should I bill for these 2 separate encounters?
A You are correct. While the modifier -59 may be assigned when a distinct and separate service was provided on the same date of service, such as when there is a separate patient encounter, the services referred to in the CPT guidelines are medicine and procedural services, not E/M services. An article in the American Medical Association’s CPT Assistant (January 1999) clarified that the modifier -59 may not be appended to E/M services.