# 51 Modifier Question



## yolwil (May 6, 2015)

I'm not sure if I'm using this modifier correctly. 

My understanding is that if multiple bilateral surgeries are done that you choose the procedure with the highest base and add modifier 51 EX: 31267.50 31255.50 31276.50 31288.50; I would bill 31267.51

And, if two or more surgical procedures are done that share the same ASA code and are not components of one another than modifier 51 should be added EX: 54324 and 54161; I would bill 54321.51

We don't bill with modifier 50 here and I'm not sure why and I've never been explained why; however I can use 51 if the insurance recognize it. Am I doing this right?


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## Nichole9288 (May 20, 2015)

Your question was posted under the anesthesia topic.  I'm thinking you may want to post your question under the appropriate topic to get an answer that will help you.


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## yolwil (May 21, 2015)

I don't think I was clear enough with my question. I want to know what is the proper use of the 51 modifier in anesthesia billing when it comes to multiple procedures?


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## dwaldman (May 23, 2015)

Modifier 51 would not be used with anesthesia since only one anesthesia code would be selected for all the procedures performed during the operation.


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## yolwil (May 27, 2015)

Below is the information I got from the CMS, so are you saying that I do not have to follow this?

E. Billing and Payment for Multiple Anesthesia Procedures
Physicians bill for the anesthesia services associated with multiple bilateral surgeries by reporting the anesthesia procedure with the highest base unit value with the multiple procedure modifier ?-51.? They report the total time for all procedures in the line item with the highest base unit value.
If the same anesthesia CPT code applies to two or more of the surgical procedures, billers enter the anesthesia code with the ?-51? modifier and the number of surgeries to which the modified CPT code applies.

Payment can be made under the fee schedule for anesthesia services associated with multiple surgical procedures or multiple bilateral procedures. Payment is determined based on the base unit of the anesthesia procedure with the highest base unit value and time units based on the actual anesthesia time of the multiple procedures. See ??40.6-40.7 for a definition and appropriate billing and claims processing instructions for multiple and bilateral surgeries.


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## BenCrocker (May 27, 2015)

Was the patient on Medicare perhaps? 

http://www.billing-coding.com/pdf/Using Modifiers Wisely 2009.pdf

See page 3/18


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## yolwil (May 27, 2015)

Thanks for the link it was very helpful!


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