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Modifier 51-I am confused

  1. Question Modifier 51-I am confused
    Medical Coding Books

    I am confused due to the following:

    CPT book guidline states Modifier 51 should not be appended to codes 93600 to 93660 however, codes in between range like 93619 and 93620 do not have the circle with the slash next to the code and the code is not listed in the appendix E modifier 51 exempt list

    WHY? can you append 51 or not?

    Help please!


  2. Default
    What insurance carrier are you billing? Medicare advises not to put modifier 51 on procedures, their edits will attach it to the procedures that need it. See thread about modifier 77 & 51, there is a link in there to a Medicare site explaining this.

  3. Default Have Answer
    I work on the payor side of coding. I did get my answer from up above when I read the AMA corrections document about how they made a mistake listing certain codes as modifier exempt when they are really not. Thanks anyway.

  4. #4
    Greeley, Colorado
    I believe you CAN use modifier -51 on those codes. AMA/CPT editorial panel did away with many modifier -51 exempt codes in 2008. According to the CPT 2008 - An Insider's View, since they changed the definition of modifier -51 exempt, the codes you stated do not meet the criteria for that exemption. Do you have this resource?

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