Wiki Modifier 51

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adunlap23

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I need help determining when to use modifier 51.
I understand that it is to be used for multiple procedures, but my question is: do I always have to use it for more than two procedures?
An example would be, the physician often performs shoulder surgery that includes procedures 29823, 29826, 29824, and 29828. I know that 29826 is an add on code and therefore modifier 51 exempt, but do I have to append modifier 51 to any of the other codes?
If anyone could answer this or guide me to a helpful website to answer my question, that would be great!
Thank you!
 
I do not use -51 on my claims. The -51 tells the carrier - this is a multiple procedure, reduce the payment. If you inadvertently put it on an incorrect code, you may receive less payment than you should.
In fact, I was told many years ago by my local MAC not to use it.
Novitas also indicates not to use it, and their claims processing system will add it where appropriate.
"Note: Medicare doesn’t recommend reporting Modifier 51 on your claim; our processing system will append the modifier to the correct procedure code as appropriate."
 
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