Ask Dr. Z

Hi Dr Z, Could you please clarify the use of the 59 modifier with moderate sedation codes 99144 and 99145. We have a case where the pt had a stent 37205 and 2 PTA's done 35474 and 35470. The 35474 and 35470 CPT codes have the bullet beside them talking about moderate sedation being integral to the procedure. The 37205 code does not. If two of these have a bullet and the one code doesn't do we still pick up the moderate sedation charges and add the 59 modifier? We ran everything through code correct and the edits are coming up for the 35474 and 35470 but not the 37205. We're not sure if we should append the 59 modifier since there was a procudre done without the bullet or if you have one with a bullet it overrides all other codes. Thanks for your help in clarifying this, Lisa C.