Doctor I work for does a lot of RFAs and prior to my time at the practice someone was using -59 for every level after the first and I knew that was wrong for the second code but the 3rd and 4th level I was not sure, the current senior coder now recommends modifier -76 on 3rd and 4th level is appropriate but I’ve been reading articles saying -59 is appropriate from a few year ago from someone in AAPC. Just for my own clarification after the second level add on, which modifier should be used with levels 3 and 4 with add on codes 64634 and 64636?

Being a new hire out of college I wanted AAPC rules and guidelines on this for 2018 laws and proper modifier usage for my own journey forward.

Thanks!