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ASC Billing modifiers

  1. Talking ASC Billing modifiers
    Medical Coding Books
    Does anyone have any insight to using modifer 51 for ambulatory surgery billing? We were advised not use 59 anymore but not quite sure 51 is appropriate for asc for multiple surgeries? thanks

  2. #2
    The -51 modifier is a physician modifier only and should not be used on ASC claims, unless specifically required by the payor

  3. #3
    I'm not quite sure why they told you not to use 59 anymore. I haven't heard that. Especially since it's an approved ASC modifier. 51 is for phsyician use only and I believe that if you append it to a claim it will deny. Medicare sometimes throws 51 on our EOBs but i have never sent one out the door.
    Why did they tell you not to use 59 anymore?
    I believe the only concern with 59 is that some facilities tend to abuse it and it raises flags for audits/investigations. As long as you stay within the guideline of the modifier then you should be fine to use it.

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