Wiki Modifier 51 and XS coded together

[Katiedid64]

We are performing an audit on some surgeries. I see that the coder has used modifier XU along with 51. There are differing opinions regarding if this is okay. It seems to me that it modifier XS provides the necessary specificity and 51 would not be appropriate to add on as well. Thoughts?
Ex: 64721-XS-51, 64708-LT

 

[Orthocoderpgu]

I don't see billing -51 with -XU or -XS as an issue especially since modifier -51 is really being faded out.

Assuming both codes are supported, I can see using modifier -XU since these procedures could be considered "over-lapping" especially since both correct nerve issues.

 

[mk2001]

We are performing an audit on some surgeries. I see that the coder has used modifier XU along with 51. There are differing opinions regarding if this is okay. It seems to me that it modifier XS provides the necessary specificity and 51 would not be appropriate to add on as well. Thoughts?
Ex: 64721-XS-51, 64708-LT

I would bill it that way as well. The XS is informing the procedure was performed on a separate structure. The 51 modifier is informing 64721 is the lowest of the 2 for the multiple surgery rule.

 

[Katiedid64]

Thanks!

 

[amyjph]

I would ask some questions first such as, who is the payer? If Medicare or the payer follows MCR, they may not want 51. 51 is becoming pretty much obsolete at this point. If the payer wants 51, then it would be appropriate on the CPT you want the multiple procedure reduction on.
Second question would be what is the 64708 being reported for with 64721? Depending, the X may be appropriate.
I would be more concerned that the coding matches the documentation and vice versa than the 51.
I probably would not cite anything at all when it comes to 51 on audits as an "error", maybe just educational info.