Hello,
I am a new member and have not seen this question in the previous threads. I am having problems this year with Medicare appending our procedures with Mod 51 and reducing our payments on 2 codes specifically.
The first is Pacer Generater Implant/Explant. We bill it as 33233-59 & 33213 We receive payment back with full payment on 33213 and reduced payment on the 33233-59 where they appended this charge with the 51 modifier. I am confused is the 59 modifier not supposed to separate this as a distinctive procedure and there for not a multiple surgery that gets ranked lower and paid at 50%?
The 2nd one is the 93543 (LV/ LA Angiography) in a cath, this is an update in 2008 that is no longer modifier 51 exempt and no matter how we bill it it gets reduced 50%. I would appreciate this in layman's terms.
thanks
Danielle B.
Greensboro Cardiology
I am a new member and have not seen this question in the previous threads. I am having problems this year with Medicare appending our procedures with Mod 51 and reducing our payments on 2 codes specifically.
The first is Pacer Generater Implant/Explant. We bill it as 33233-59 & 33213 We receive payment back with full payment on 33213 and reduced payment on the 33233-59 where they appended this charge with the 51 modifier. I am confused is the 59 modifier not supposed to separate this as a distinctive procedure and there for not a multiple surgery that gets ranked lower and paid at 50%?
The 2nd one is the 93543 (LV/ LA Angiography) in a cath, this is an update in 2008 that is no longer modifier 51 exempt and no matter how we bill it it gets reduced 50%. I would appreciate this in layman's terms.
thanks
Danielle B.
Greensboro Cardiology