Wiki Modifier -51

[kristinab]

I need some insight on the modifier -51. We have a patient that had two MRI's done on the same day. One was done on the left knee and the other was done on the right knee. Should the modifier -51 be appended to the second MRI?

 

[mitchellde]

I would use the 50 modifier for bilateral or depending on the payer Lt on one line and RT on the other

 

[Lisa Bledsoe]

I would start with LT and RT. Usually radiology codes are not submitted with modifier -50.

 

[kristinab]

Does the second procedure require a modifier? A modifier was put on it and I didn't see anything in any of the guidelines, ect. It was paid with a -51 but it was also paid at a reduced fee.

 

[Lisa Bledsoe]

Does the second procedure require a modifier? A modifier was put on it and I didn't see anything in any of the guidelines, ect. It was paid with a -51 but it was also paid at a reduced fee.

I don't believe mod -51 is appropriate for an MRI of the knee. It should be billed with RT, LT, or 50 (again I prefer RT and LT). No reduced fee should be applied. Are you billing the radiologist (professional) or technical side?

 

[mitchellde]

Agree, I use the 50 especially for Medicare and some of the commercials but LT, RT for BCBS so it just depends, but no need for a 51.

 

[LTibbetts]

I agree also. LT & RT are the way to go with those.