# Mod 51 vs Mod 59 for ASC use



## Tracy592 (Jul 8, 2015)

Is Modifier 51 an approved Modifier for ASC Outpatient Claims?


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## nsteinhauser (Jul 8, 2015)

Not according to the current CPT book.  In Appendix A, under 'Modifiers Approved for Ambulatory Surgery Center (ASC) Hospital Outpatient Use,' -51 is not listed.  However every payer is different - I haven't come across one in 10+ years but there may be payers out there that want -51's on ASC claims.


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## ramciver (Jul 8, 2015)

*Modifier 51*

This is what I found on a Billing website................


What is Modifier -51 and when to use?


When and How Do I Use Modifier -51? What is Modifier -51 anyway?

 Modifier -51, Multiple Procedures

 This modifier is used when reporting multiple procedures performed by the same physician on the 
 same day. Do not use this modifier for "add-on" codes (see appendix D of the CPT Code book). Do 
 not use this modifier for codes with "modifier -51 exempt" symbol (see appendix E of the CPT Code 
 book). Do not use this modifier with an E/M code. This modifier can only be used by the same 
 physician on the same day who performed the procedure.

 Coding tip: List the highest reimbursable code (after the main procedure code) based on the fee 
 schedule.


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## ramciver (Jul 8, 2015)

*modifier 51 - Hope this helps.......No Modifier 51 on list*

MODIFIERS APPROVED FOR AMBULATORY SURGERY CENTER (ASC) HOSPITAL OUTPATIENT USE


25 Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the
 Same Day of the Procedure or Other Service
 27 Multiple Outpatient Hospital E/M Encounters on the Same Date
 50 Bilateral Procedure
 52 Reduced Services
 58 Staged or Related Procedure or Service by the Same Physician During the Postoperative Period
 59 Distinct Procedural Service
 73 Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the
 Administration of Anesthesia
 74 Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure After Administration
 of Anesthesia
 76 Repeat Procedure by Same Physician
 77 Repeat Procedure by Another Physician
 78 Return to the Operating Room for a Related Procedure During the Postoperative Period
 79 Unrelated Procedure or Service by the Same Physician During the Postoperative Period

Level II (HCPCS/National) Modifiers

 E1 Upper left, eyelid
 E2 Lower left, eyelid
 E3 Upper right, eyelid
 E4 Lower right, eyelid
 F1 Left hand, second digit
 F2 Left hand, third digit
 F3 Left hand, fourth digit
 F4 Left hand, fifth digit
 F5 Right hand, thumb
 F6 Right hand, second digit
 F7 Right hand, third digit
 F8 Right hand, fourth digit
 F9 Right hand, fifth digit
 FA Left hand, thumb
 GA Waiver of Liability on file
 GC Resident/Teaching Physician Service
 GE Resident Primary Care Exception
 GV Attending Physician not hospice
 GW Service unrelated to terminal condition
 LC Left circumflex coronary artery (Hospitals use with
 codes 92980-92984, 92995, 92996)
 LD Left anterior descending coronary artery (Hospitals
 use with codes 92980-92984, 92995, 92996)
 LT Left side (used to identify procedures performed on
 the left side of the body)
 QM Ambulance service provided under arrangement by
 a provider of services
 RC Right coronary artery (Hospitals use with codes
 92980-92984, 92995, 92996)
 RT Right side (used to identify procedures performed
 on the right side of the body)
 T1 Left foot, second digit
 T2 Left foot, third digit
 T3 Left foot, fourth digit
 T4 Left foot, fifth digit
 T5 Right foot, great toe
 T6 Right foot, second digit
 T7 Right foot, third digit
 T8 Right foot, fourth digit
 T9 Right foot, fifth digit
 TA Left foot, great toe


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