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Modifier 51 in Outpatient Hospital Setting...

mbort

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modifier 51 was designed for physicians, if you are coding for a physician then yes.

if you are coding for the facility then the applicable outpatient hosp modifiers are on the inside front cover of the 2008 CPT Professional Edition, left column.
 
Last edited:

nycoder

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^^Thanks for your response. I'm aware that modifier 51 doesn't fall under the group of modifiers approved for hospital outpatient use but what would be the equivalent of modifier 51 for use in an outpatient hospital setting? I'm curious what differing opinions might come up.

Thanks!
 

Anna Weaver

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mod 51

I always used the 59 modifier when I coded for the facility side. I used the 51 for the physician side. Sometimes I still use a 59 even on physicians, it just depends. But I never used the 51 on the facility at all, in fact, our encoder would flag us and tell us, you can't do that!!! :eek: And as stated in the previous post, The modifiers in front of CPT book tells you it's not on the approved list for Hospital outpatient use.
 

nycoder

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I always used the 59 modifier when I coded for the facility side. I used the 51 for the physician side. Sometimes I still use a 59 even on physicians, it just depends. But I never used the 51 on the facility at all, in fact, our encoder would flag us and tell us, you can't do that!!! :eek: And as stated in the previous post, The modifiers in front of CPT book tells you it's not on the approved list for Hospital outpatient use.

Thank you very much for your input. This is what I was leaning towards...I just wanted confirmation from other coders who have come across this situation. It's interesting that you can use mod 59 for physicians...

Thanks again!
 
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