Wiki Modifier 51-anyone know whether

[coders_rock!]

Does anyone know whether or not there are any exceptions to Medicare accepting modifier 51?

 

[RebeccaWoodward*]

Does anyone know whether or not there are any exceptions to Medicare accepting modifier 51?

Our carrier (Cigna Gov) prefers leaving this modifier off....

Modifier "51" is not required for billing purposes. The carrier will assign the "51" modifier as appropriate based on the services billed.


WPS (another example): Medicare does not recommend reporting Modifier 51 on your claim; the processing system has hard-coded logic to append the modifier to the correct procedure code

Is this the answer you were looking for?

 

[coders_rock!]

Our carrier (Cigna Gov) prefers leaving this modifier off....

Modifier "51" is not required for billing purposes. The carrier will assign the "51" modifier as appropriate based on the services billed.


WPS (another example): Medicare does not recommend reporting Modifier 51 on your claim; the processing system has hard-coded logic to append the modifier to the correct procedure code

Is this the answer you were looking for?

Yes this is Rebecca, my assumption was that they do not require the modifier. I wanted to be certain. Thanks for your prompt and accurate response.

 

[RebeccaWoodward*]

Happy to help~

 

[gailmc]

Our Medicare Carrier WPS does not require the -51modifier nor does any of our commerical payers. DHS/Medicaid is our only payer that requires it.