Check With Payers for Modifier 51 Specifics
Question: Can I use modifier 51 on secondary or other additional post-op pain blocks? Delaware Subscriber Answer: Modifier usage isn’t consistent across the board, so you need to check with your respective payer about whether they require a modifier — and, if so, which specific one — on additional blocks. For example, modifier 51 (Multiple Procedures) may be preferred by some payers, but modifier 59 (Distinct Procedural Service) may be preferred by others. The American Society of Anesthesiologists (ASA) says that modifier 51 applies to situations including “A single procedure performed multiple times at the same site,” which could make it appropriate for this situation. ASA says the indications for modifier 59 include: From the brief information you supply, none of the aforementioned situations for modifier 59 apply for a secondary postoperative pain block, so modifier 51 is your better bet. Still, you should always check with your respective payer for certainty. Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
