modifier 51

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175
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Colorado Springs, CO
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My company is making us add modifier 51 to any and all procedures after the first one, even add on codes. They want it whether there is a CCI edit for those codes or not. If those codes need other modifiers we have to put 51 first then whatever other one is needed second.
They say this is for accounting and to give the providers proper revenue but this scares me.
That is not proper coding to just add modifier 51 no matter what. I asked if the modifier dropped off before the claim goes out but it does not. So we are going to be submitting tons of modifier 51s to our payers and I feel that it will raise a red flag because that modifier is pretty obsolete.
I wanted to see what others thought about this and if there are any resources that i can give to my manager to prove that this is not ok.
 
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It has to do with providers receiving RVU credits. This came up before in another thread, but I can't find it now. I suggested that the person escalate the issue to a compliance officer in the facility they work for, or someone of equal authority. If you're billing what you know is incorrect, then you could wind up in hot water. Personally, I'd refuse to code incorrectly just to make sure I'm covered. If they want to enter the charges incorrectly, that's on their shoulders to do. There are additional routes you can take, such as reporting the problem to the appropriate state or federal agencies. There are anti-retaliation laws in place to make sure you're protected.

Bottom line as far as I'm concerned, if the only way they can capture the RVUs is by forcing you to bill improperly, then THEY need to correct their reporting software.
 
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