One of the most common things I see during facility audits is the misuse and overuse of modifier -59, distinct procedural service, which inadvertently snowballs into the unbundling and upcoding of surgical procedures. Not only does the application of modifier -59 to each CPT code listed in an operative session warrant closer scrutiny from my team, but it also waves an ominous red flag for Medicare and the Office of Inspector General (OIG).