Reader Questions:
Same Day Second Procedure Billing
Published on Tue Dec 01, 1998
Question: When both a peripheral angiogram of the legs and a cardiac cath are done on the same day, why is the second procedure reduced by 50%? (Modifier -51 was appended to 93510, left heart catheterization.)
Texas cardiology practice
Answer: In this case, when modifier -51 is appended to the second procedure, Medicare will pay 100% of the global fee for the highest value procedure and 50% of the global fee for the subsequent procedure.
(Tip: The second through the fifth procedure will be reduced by 50% when you use modifier -51.)
In addition, always list the most expensive procedure first, followed by the less expensive ones. This way there is never any doubt as to which procedure should be paid at 100% and which one(s) should be paid at 50%.
