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Try CasePilot| Short Descr | Esophag muc integ w/eso egd | Coverage | Special coverage instructions apply | Pricing Indicator(s) | 53 – Statute | MPI | A – Not applicable, as HCPCS priced under one methodology | Statute | 1833(t) | ASC Payment Group Code | YY – 1/01/2022 | BETOS | P8B – Endoscopy - upper gastrointestinal | TOS Code(s) | 2 – Surgery | Added Date | 4/1/2021 | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | MUE | 1 | MUE | Not applicable/unspecified. | OTS Orthotic | No |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) |
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| 2022-01-01 | Changed | Description changed |
| 2021-04-01 | Added | Code added. |
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