tci ED Coding & Reimbursement Alert - 2009 Issue 6

READER QUESTIONS: Use This Advice on Reporting Modifier 51

Question: I am uncertain about when I should use modifier 51. Do some carriers no longer accept it? Wisconsin SubscriberAnswer: Including modifier 51 (Multiple procedures) on certain claims may not be necessary for all insurers. Many carriers no longer require modifier 51. Processing claims electronically allows the carrier to recognize when your physician performs multiple procedures and automatically make the necessary reduction in payment. Remember to always list the highest-paying procedure code first.Tip: Make a pre-emptive strike against denials by contacting your insurance carrier and asking the representative which method the insurer would prefer when reporting multiple surgical...

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