Wiki Modifier 59

[dray01]

I am wondering if coders are utilizing modifier 51 or if they are relying on the insurances to know the code should be paid at 50% based on the multiple code rule?

 

[dclark7]

It depends on whether or not the insurance company wants the modifer (51). Medicare automatically adds it based on RVUs and some other insurance companies do the same. Your best bet is to check with the insurance companies you contract with and find out how they want this billed.

 

[kathy a]

I was told by my senior coder the other day to not use modifier 51-that they are doing away with that, and that I should be using modifier 59. Has anyone heard of this..because I haven't. I use the specialy coding books and go by what they tell me to use? I also know that you should not abuse modifier 59.
Kathy Albert-CPC

 

[DOVERRED]

the modifier 51 is use on the pro side whereas the 59 is use on the facility side