Wiki Modifier 51 on diagnostic test codes

[rainagates]

Does modifier 51 apply to diagnostic procedure codes or just surgical codes? If it applies to diagnostic codes, under what circumstances should it be used? What about ophthalmology diagnostics - if one procedure is performed by a tech and another by the physician, should we use modifier 51?

 

[GaPeach77]

51 modifier is most appropriately used for surg codes in order for the payor to utilize the multiple surg pricing rules. For diagnostic testing you need to use a 59 or a 76 depending on the payor. For example, BCBS likes 76 for diagnostic procedures whether it is a repeat diagnostic test or not.