DEDGE CGIC
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Does anyone know when and why United health care is no longer ackonowledging the 51 modifier?
Per their re-bundling policy and the rep I spoke with this is off their site:
Modifiers
Modifiers offer the physician or healthcare professional a way to identify that a service or procedure has been altered in some way. Under appropriate circumstances, modifiers should be used to identify unusual circumstances, staged or related procedures, distinct procedural services or separate anatomical location(s).
UnitedHealthcare recognizes the following designated modifiers under this reimbursement policy:
25, 50, 58, 59, 78, 79, 91, E1, E2, E3, E4, LC, LD, LT, RC, RT, TA, T1, T2, T3, T4, T5, T6, T7, T8, T9, FA, F1, F2, F3, F4, F5, F6, F7, F8 and F9.
Modifiers offer specific information and should be used appropriately. It is inappropriate to use modifier 76 to indicate repeat laboratory services. Modifiers 59 or 91 should be used to indicate repeat or distinct laboratory services, as appropriate, according to the AMA and CMS. Separate consideration for reimbursement will not be given to laboratory codes reported with modifier 76.
51 is not listed and we are starting to get more and more bundling denials connected to this issue.
Per their re-bundling policy and the rep I spoke with this is off their site:
Modifiers
Modifiers offer the physician or healthcare professional a way to identify that a service or procedure has been altered in some way. Under appropriate circumstances, modifiers should be used to identify unusual circumstances, staged or related procedures, distinct procedural services or separate anatomical location(s).
UnitedHealthcare recognizes the following designated modifiers under this reimbursement policy:
25, 50, 58, 59, 78, 79, 91, E1, E2, E3, E4, LC, LD, LT, RC, RT, TA, T1, T2, T3, T4, T5, T6, T7, T8, T9, FA, F1, F2, F3, F4, F5, F6, F7, F8 and F9.
Modifiers offer specific information and should be used appropriately. It is inappropriate to use modifier 76 to indicate repeat laboratory services. Modifiers 59 or 91 should be used to indicate repeat or distinct laboratory services, as appropriate, according to the AMA and CMS. Separate consideration for reimbursement will not be given to laboratory codes reported with modifier 76.
51 is not listed and we are starting to get more and more bundling denials connected to this issue.