1. QuickEMR will add a 59 modify only if it is needed according to the CCI Edit rules found in the main menu under "Billing" => "CCI Edits".

2. According to your CCI Edit list the 97113 (Aquatic therapy) will recieve a 59 modifer if it is pared with 97150 (Group Therapy) or 97530 (Therapeutic/Functional Activities).

3. One of the notes in question (G. Lott 7/13/2018,was copied from a later note on the same patient (7/16/2018). 7/16/18 has 97530 (Therapeutic/Functional Activities) leading to the following scenario.

4. Therapist (Elizabeth Bigelow) copies note 7/16/18 as a template for a note on 7/13/18. This copies forward the charge 97530 (Therapeutic/Functional Activities).

5. Therapist adds 97113 (Aquatic Therapy/Exercises). As 97530 is present this triggers the 59 modifier to be added to the new charge 97113.

6. Therapist then deletes 97530 (Therapeutic/Functional Activities).

7. The 59 modifier is not needed any longer. However QuickEMR will not remove modifiers from charges. The 52 modifier is probably a similar scenario.

Solution

1. Create a policy for your therapists to remove unused charges from the note before adding new ones.

2. Review the note before marking complete to insure the modifiers are correct.

3. Disable the CCI edit policy (not recommended as it may actually be needed in the future).

QuickEMR will maintain it's policy of keeping modifiers. This is to prevent the system from deleting modifiers manually added by the therapists.