multiple procedure reimbursement

[cheryl-spears@cherokee.org]

provider sent in claim listing 64910 LT, 26350 51, 26350 59..POS 22. Would the primary code 64910 be reimbursed at full rate and the other two codes split or would the primary code be reimbursed at full rate then 26350 51 reimbursed at full rate and 26350 59 reimbursed at split rate?

this discussion seems to be thrown back and forth in our office. What is the best solution to this?

[jmcpolin]

The primary CPT should be 100 and then the next 2 codes should be 50 percent, plus the 51 modifier (which I never use) is telling the insurance company to reduce the second procedure 50 percent, when most insurance companies especially Medicare reduce the second, third etc. by 50 percent.