Complex Sim (77290) with CT Guidance (77014)- 2 separate locations/same day

I have a scenario where the patient has 2 locations being treated the same DOS. Both are Mets.
1. Ribs and T-spine
2. Pelvis and Femur

Do payers require the first Sim/CT be coded with 198.5 and the second Sim/CT be coded with a primary dx of 192.2. It seems both procedures should all be coded with 198.5.

Do 77290 and 77014 require a 59 modifier to identify that two different areas were treated the same day?

77290
77290-59

77014
77014-59

Please include supporting documentation for your answer.

Thanks!
Melissa