Gastroenterology Coding Alert

Question: Do you have to use modifier -51 every time you code a visit where the gastroenterologist performs multiple procedures?

Hawaii Subscriber

Answer: No. There is a complete list of modifier -51 (Multiple procedure) exempt codes in Appendix E of CPT 2004. The list is "a summary of CPT codes that are exempt from the use of modifier -51 but have not been designated as CPT add-on procedures/services," according to CPT.

These mod -51 exempt codes are also recognizable within the code listings of CPT; just look for a "circle with a slash" symbol to the left of the code. Get to know them before filing modifier -51 claims to prevent red tape and increase your practice's productivity.

-- Reader Question and You be the Expert were reviewed by Catherine Brink, CMM, CPC, president of Healthcare Resource Management in Spring Lake, N.J.