Wiki Use of modifier 51

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pattimower

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My question is should you use Modifier 51 for more than one anatomical site for a procedure, or using it once covers all sites involved?
Patti Mower
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New question.... RE" cpt codes 99478-99480

Are these codes not to be used with 36510, 36000, 43752, 51100, 94660, 94375 because they are bundled? Or is this 'old' protocol?
 
Modifier -51

For my coding homework in college, we had a case where -51 was used two times on two different codes. The codes we had were: 31256-LT, 31254-51-LT and 31240-51-LT, where 2 separate procedures were performed. If a single procedure inherently involves more than one anatomical site, I think -51 would not be used. If a single procedure inherently involving more than one anatomical site is done AND one other procedure is also done, I would use -51 for the other procedure.
 
If more than one surgical procedure is performed. Modifier 51 is applied on the second and subsequent operative procedures when the procedures are ranked in RVU order. Except for add-on codes (the ones with the plus sign) and any codes that are modifier 51 exempt (Circle with a slash through it)

Most payers including Medicare advise not to add modifier 51 on any claims and to allow their claims processing systems to apply it. You still need to know when and what codes need modifier 51 to be sure the payer didn't make an error. Plus when taking an exam as they may test on the modifier 51 concept.

Modifier 51 us related to multiple surgery reduction where the secondary, tertiary and beyond are paid at less than 100% of the Allowed. Modifier 51 does not go on any E&M. Also don't confuse this with modifier 59 which is for bypassing of NCCI edits if specific criteria is met.

Patti Mower said:
Are these codes not to be used with 36510, 36000, 43752, 51100, 94660, 94375 because they are bundled? Or is this 'old' protocol?
Click to expand...

There have been no changes regarding what is inclusive in Pediatric and Neonatal Critical and Intensive care. They are still bundled so no modifier 51 or 59.
 
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modifier 51 use

When billing for a colonoscopy & EGD is use of modifier 51 appropriate on one of the codes? Our billing company is telling us not to use, that it is "old school"
 
modifier 51 use

When billing for a colonoscopy & EGD is use of modifier 51 appropriate on one of the codes? Our billing company is telling us not to use, that it is "old school"
 
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