• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki medicare adding 51 to procedures??

Create Wiki
K

kristenw

Guest
Messages
4
Best answers
0
Has anyone noticed medicare automatically adding modifier 51 to procedures that were performed on the same such as an echo and a nuclear study they are automatically reducing the payment. Modifier 59 was added already when original claim was sent out.
what has been your experience with Medicare with this???
 
They do that to us a lot. What you need to watch for is if the codes they are adding 51 modifiers are "51 exempt." what I mean by that is some codes you do not have to put 51 modifier on them because the AMA says they are not subject to a multiple procedure reduction. The AMA puts out very well written books on codes. Our office has one specifically for our practice. each procedure code gets a page dedicated to it where you can see what you can and cannot bill with that code.

If these codes are 51 exempt then you will have to appeal it. If your documentation is good they should overturn it.
 
Medicare will add a 51 modifier to codes that the multiple procedure reduction applies too. This is new for stress and echo in 2013. However you do not need the 59 modfier on those codes.
 
You must log in or register to reply here.
Top