tci General Surgery Coding Alert - 2004 Issue 10

Reader Questions: For Most Payers, You No Longer Need -51

Question: I noticed that CPT includes modifier -51 for "multiple procedures." I never append this modifier when reporting multiple procedures (such as same-day bariatric surgery and cholecystectomy) and have never had difficulties with the payer. Am I facing a possible audit?Pennsylvania Subscriber Answer: More than likely, your payer doesn't require modifier -51 (Multiple procedures), and you are in no danger of an audit because you have failed to append the modifier to multiple procedure claims.  Many payers, including the majority of Medicare carriers, use software that automatically detects second and subsequent procedures and reimburses them accordingly...

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