Question Lap tubal w/ Hysteroscopy D&C and endometrial ablation

such78

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when 58563 is performed with another separately identifiable procedure, the highest dollar value code is listed as the primary procedure and subsequent procedures are appended with mod-51.
 

csperoni

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I was told many many years ago at a Medicare seminar that there is no need for us to add -51. The claims processing systems will automatically pay the highest at full, then add -51 to secondary for 50% payment.
In fact, I have seen commercial insurance situations where someone used -51 on the wrong procedure and as a result, we were shortchanged payment. It's then a whole process to submit a corrected claim, appeal, etc.
I have not used -51 in at least 10 years.
For a reference, here is Novita's page about -51 where they state it is not recommended. https://www.novitas-solutions.com/w...ntentId=00144532&_adf.ctrl-state=86hvagjfk_33
 

mllivers

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I was told many many years ago at a Medicare seminar that there is no need for us to add -51. The claims processing systems will automatically pay the highest at full, then add -51 to secondary for 50% payment.
In fact, I have seen commercial insurance situations where someone used -51 on the wrong procedure and as a result, we were shortchanged payment. It's then a whole process to submit a corrected claim, appeal, etc.
I have not used -51 in at least 10 years.
For a reference, here is Novita's page about -51 where they state it is not recommended. https://www.novitas-solutions.com/w...ntentId=00144532&_adf.ctrl-state=86hvagjfk_33
Interesting, thank you for that article!
 
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