Ophthalmology and Optometry Coding Alert

Question: I previously often used modifier 51. Now, I'm unsure when it is required. Do some carriers no longer accept it? Kansas Subscriber Answer: Appending modifier 51 (Multiple procedures) on certain claims may not be necessary for all insurers. Many carriers no longer require modifier 51. Processing claims electronically allows the carrier to recognize when your physician performs multiple procedures and automatically make the necessary reduction in payment. Remember to always list the highest-paying procedure code first. Tip: Make a pre-emptive strike against denials by contacting your insurance carrier and asking the representative which method the insurer would prefer when reporting multiple surgical procedures. Note each payer's policy on coding multiple procedures so you can reference it quickly the next time a modifier 51 issue arises. Rule of thumb: Modifier 51 is an informational-type modifier for use on the second, third, etc., surgical procedure performed on the same day as [...]