Otolaryngology Coding Alert

Question: I am uncertain about when I should use modifier 51. Do some carriers no longer accept it? Wisconsin Subscriber Answer: Including modifier 51 (Multiple procedures) on certain claims may not be necessary for all insurers. Many carriers no longer require modifier 51. Processing claims electronically allows the carrier to recognize when your physician performs multiple procedures and automatically make the necessary payment reduction. You should list the highest-paying procedure code first. Tip: Make a pre-emptive strike against denials by contacting your insurance carrier or Medicare Administrative Contractors (MAC) and asking the representative which method the insurer would prefer when reporting multiple surgical procedures. Then, make a note of each payer's policy on coding multiple procedures so you can reference it quickly the next time a modifier 51 issue arises. Rule of thumb: Modifier 51 is an informational-type modifier for use on the second, third, etc., surgical procedure performed on [...]