tci Part B Insider - 2016 Issue 10

Modifiers: CMS Says 'Use Modifier 51'--Some MACs Say 'Not So Fast'

Conflicting information can be confusing about the multiple procedures modifier. Coders got both good news and bad news this week, when CMS offered some words of wisdom on modifier 51 (Multiple procedures). The good news was that a CMS representative provided excellent advice on how to use this modifier. The bad news? Payers have been saying for years that they don’t want you to use it on your Medicare claims. To navigate the variations between Medicare’s advice and your MACs’ preferences, you’ll have to cross-reference your payer policies with Medicare’s regulations. Use Modifier on &lsquo...

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