I have a provider, who is paid by RVU’s, and he is wanting to bill out multiple procedures on separate HCFA’s. Example, he does two different procedures, and instead of billing both out with 59 modifier on second procedure, he wants to bill out each procedure on separate HCFA. The payment modifiers change how his RVU’s are counted. If the procedures are billed out separate, in his mind, you don’t have to put the 59, thus giving him 100% value for both procedures. I have looked through CMS guidelines and I don’t see anything stating if more than one procedure is done in the same day, that they all have to be billed out on same HCFA. If anyone knows where I can find some guidelines in regards to this, I would greatly appreciate it. The provider is saying it is incorrect to bill them all out on same form, so I just need something in writing from CMS to show him otherwise. Thanks in advance for any help!
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