Urology Coding Alert

If you automatically append modifier -51 to multiple surgeries performed by the same physician on the same day, you could be penalized with a denial from your Medicare carrier. Certain Medicare carriers have amended their modifier -51 (Multiple procedures) policies to state, "It is no longer necessary to report the -51 modifier for multiple surgeries," as stated by Empire Medicare Services in New York and New Jersey.

According to Empire Medicare's new policy, "The carrier will determine multiple surgical pricing accordingly. If you disagree with the carrier's determination on pricing, you would need to file an appeal."

The reasoning? Empire Medicare asserts that "in certain instances, use of the -51 modifier may cause a procedure to deny because the particular CPT Code is not subject to multiple surgery guidelines and thus the -51 modifier would be inappropriate."

Check your Medicare carrier's Web site or news bulletin to be sure you're abiding by your carrier's current policy on reporting multiple procedures.