Question: Dr. Becker performed repairs of the extensor carpi ulnaris, extensor digiti minimi, and extensor digitorum to the ring and small fingers of the patients left hand. We originally coded this with 25270 x5 without the modifier -51. The patients insurance company paid the appropriate amount for the first code and then cut the additional codes by 50 percent. I thought that when the CPT stated each tendon or each additional that the multiple procedure rule was not used.
Jodi Cornell
Office of Thomas Becker, MD, Gurnee, Ill.
However, 25270 (repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle) lists each tendon, so multiple rules apply since the same code is used for one procedure or for more than one.
Note: Modifier -51 (multiple procedures) should be used in this caseon the subsequent codes, not on the first one.