Part B Insider (Multispecialty) Coding Alert

Published on Tue Aug 02, 2011 PDF

Question: If a code has global period designation in the fee schedule which implies that it has no global period, does that mean you don't need modifier 51 (Multiple procedures)?

Answer: Since Medicare automatically adjusts for reduction, carriers do not require 51. For private payers, the user should apply 51 to the multiple procedures beyond the primary procedure unless the codes are designated as modifier 51 exempt in CPT®. Modifier 51 is not related to global concept, but rather is for reporting multiple procedures done in a common session, be it within or outside the global period. You may or may not append modifier 51 to secondary codes, based on particular carrier's guidelines.