Modifier 51 is used in medical coding to indicate that multiple procedures were performed during the same session. It signifies that the primary procedure is the first listed, and any subsequent procedures are secondary and may be subject to reduced payment. Importantly, modifier 51 should not be applied to codes that are exempt from its use, such as certain surgical procedures and those with specific modifiers. This modifier helps ensure accurate billing and reimbursement for healthcare providers.
Modifier -51
modifier -51
multiple procedures
The modifier commonly used with add-on codes is Modifier 51. This modifier indicates that multiple procedures are being performed during the same session, with one primary procedure and additional secondary procedures identified by the add-on codes. However, it's important to note that add-on codes themselves should not be reported with Modifier 51, as they are inherently understood to be additional procedures. Instead, the primary procedure should be marked with Modifier 51 if necessary.
multiple procedures, -51
FALSE
yes
Modifier -51 is used in coding to indicate that multiple procedures were performed during the same session. For the code 51797, which refers to a specific procedure related to the urinary system, you would add modifier -51 if you are reporting multiple procedures and the payer requires it to indicate that the primary procedure is being billed alongside additional ones. However, if 51797 is the only procedure being billed, then modifier -51 is not necessary. Always check with the payer’s guidelines for specific requirements.
add-on
Modifie 51 is appended to indicate that multiple surgeries performed on the same day, during the same surgical session.
Modifier 51 is a Current Procedural Terminology (CPT) code modifier used to indicate that multiple procedures were performed during the same session by the same provider. It signifies that the primary procedure is being reported first, followed by additional procedures that are considered secondary. This modifier helps to ensure that payment is appropriately adjusted to account for the performance of multiple services, as typically, the first procedure is reimbursed at full value while subsequent procedures may receive reduced payment. It is important to note that modifier 51 should not be used with certain codes that are exempt from multiple procedure reductions.
Appendix E