20160831 - FREE Code Books with Exam Prep Packages | Learn More

AAPC - August DL Sale: 50% OFF
Results 1 to 6 of 6

Thread: Modifier 51 in Outpatient Hospital Setting...

  1. #1
    Join Date
    Apr 2007
    Location
    Jamaica, NY
    Posts
    18

    Default Modifier 51 in Outpatient Hospital Setting...

    Question: Can Modifier 51 be used in an outpatient hospital clinic?

    Thank you for any advice you can offer.

  2. #2
    Join Date
    Apr 2007
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338

    Default

    modifier 51 was designed for physicians, if you are coding for a physician then yes.

    if you are coding for the facility then the applicable outpatient hosp modifiers are on the inside front cover of the 2008 CPT Professional Edition, left column.
    Last edited by mbort; 09-15-2008 at 12:00 PM. Reason: added afterthought

  3. #3
    Join Date
    Apr 2007
    Location
    Jamaica, NY
    Posts
    18

    Default

    ^^Thanks for your response. I'm aware that modifier 51 doesn't fall under the group of modifiers approved for hospital outpatient use but what would be the equivalent of modifier 51 for use in an outpatient hospital setting? I'm curious what differing opinions might come up.

    Thanks!

  4. #4
    Join Date
    Apr 2007
    Location
    Kokomo, IN
    Posts
    769

    Default mod 51

    I always used the 59 modifier when I coded for the facility side. I used the 51 for the physician side. Sometimes I still use a 59 even on physicians, it just depends. But I never used the 51 on the facility at all, in fact, our encoder would flag us and tell us, you can't do that!!! And as stated in the previous post, The modifiers in front of CPT book tells you it's not on the approved list for Hospital outpatient use.

  5. #5
    Join Date
    Apr 2007
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338

    Default

    there is no equal to the 51 for the facility side, we dont need to report multiple procedures like the physicians do.

  6. #6
    Join Date
    Apr 2007
    Location
    Jamaica, NY
    Posts
    18

    Default

    Quote Originally Posted by Anna Weaver View Post
    I always used the 59 modifier when I coded for the facility side. I used the 51 for the physician side. Sometimes I still use a 59 even on physicians, it just depends. But I never used the 51 on the facility at all, in fact, our encoder would flag us and tell us, you can't do that!!! And as stated in the previous post, The modifiers in front of CPT book tells you it's not on the approved list for Hospital outpatient use.

    Thank you very much for your input. This is what I was leaning towards...I just wanted confirmation from other coders who have come across this situation. It's interesting that you can use mod 59 for physicians...

    Thanks again!

Similar Threads

  1. 29581 Bilateral-Outpatient Setting
    By jmontoya in forum Billing/Reimbursement
    Replies: 2
    Last Post: 01-28-2014, 12:00 PM
  2. hospital outpatient setting chemotherapy
    By jhkimmc in forum Hematology/Oncology
    Replies: 0
    Last Post: 12-11-2013, 06:13 AM
  3. Replies: 3
    Last Post: 05-21-2010, 04:05 PM
  4. Replies: 0
    Last Post: 05-07-2009, 09:40 AM
  5. Dialysis patient in the outpatient setting
    By ajenkins in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 01-22-2009, 11:58 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.