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What is the 51 modifier used for?

May 31, 2020 by Rhyley Bryan

What is the 51 modifier used for?

Modifier 51 is used to identify the second and subsequent procedures to third party payers. The use of modifier 51 indicates that the multiple procedure discount should be applied to the reimbursement for the code.

How do you know when to use modifier 51?

Modifier 51 comes into play only when two or more procedures are performed. It is not to be used when a procedure is performed along with an Evaluation and Management (E/M) service. There are instances where multiple procedures are performed but modifier 51 is not appropriate.

How do you use modifier 51?

CPT guidelines explain the 51 modifier should apply when “multiple procedures, other than E/M services, are performed at the same session by the same individual. The additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s).”

What is the difference between modifier 51 and 59?

Modifier 59 is used to indicate that two procedures are distinct procedures which are performed at different times and/or locations whereas modifier 51 is used when same physician performes more than two procedure at the same time.

What does 51 modifier mean?

When to use modifier 51 and 59 in CPT?

Modifier 51 vs Modifier 59. Modifiers provide additional information about CPT® codes submitted and services rendered without changing the definition of the procedure code itself. Modifiers 51 and 59 are both used when multiple services are performed during a single encounter, but they serve different purposes.

Does modifier 51 effect payment?

Yes, modifier 51 causes a 50% reduction in payment. Let’s clarify a couple of points here. 1. Most carriers add modifier 51 for you automatically and don’t require you to add it. 2. Modifier 51 has to do with the multiple surgery reduction rule.