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Primary Care Coding Alert

Reader Question:

Multiple Procedures Modifier

Published on Sun Jul 01, 2001

Question: When I add modifier -51 to a claim, does it matter what procedure codes I append it to? A co-worker said I should always add it to the lower-paying claim because that one will be reimbursed only at 50 percent.

Arizona Subscriber

Answer: While it doesnt hurt to attach modifier -51 (multiple procedures) to the least expensive service, there is no regulation to that effect. In fact, Medicare policy indicates that it will automatically reduce the lesser charge when two (or more codes) are reported with the multiple procedures modifier. Some coding experts, however, recommend you append it to the lower-paying service as insurance against a Medicare error.
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