Medical Billing Blog: Section - Modifier 51

Archive of all Articles in the Modifier 51 Section

This is the archive containing links to all articles written in the Modifier 51 section of our blog.

Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.

Outsourcing a Dirty Word toYou?

The word “outsourcing” has become a dirty word for many physicians that have been burned by medical billing companies that either outsourced their claims to medical billing companies that use neither secure networks nor adhere to HIPAA regulation in order to maximize their profits; or the outsourcing company just turned out to not be reliable and it wound up costing the practice money to utilize their services. Don’t let a bad experience keep you from partnering with a legitimate medical billing company that can not only help you get your reimbursements faster but also realize great profits by maximizing every single medical billing claim that is filed to make sure

By: Melissa Clark, CCS-P, RT - CEO
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October Updates Are In Effect!

If you haven’t already, make sure that your staff is using the updated CPT codes that were released in October 2008. Not doing so can lead to kick backs that will require more staff hours to research, redo and resubmit and if this happens on a number of claims it can seriously affect your reimbursements and in turn – slow your revenue flow to a mere trickle. One way to avoid this dilemma is to outsource your medical billing and yes, there are some horror stories out there about outsource companies that threw away patient billing, had lax attitudes towards billing submissions and wound up costing the physician a lot

By: Melissa Clark, CCS-P, RT - CEO
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Get Better Reimbursements on Common ER Procedures

Knowing when to use code 90782 in emergency department procedures can help with your medical billing reimbursements. For example, if a doctor examines a patient in the ED for an injury, and injects a preventative tetanus toxoid, your first instinct might be to use 90782 as a modifier for this procedure. But you would not receive a medical billing reimbursement because the incident to provision does not apply in the emergency department so you would not be able to justify having the doctor administer this injection. There would be no way to justify the medical necessity of such a shot. However, when you are in an office setting the CPT

By: Melissa Clark, CCS-P, RT - CEO
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Correct Use of Modifier 51

The multiple procedure code Modifier 51, causes some confusion among medical billing professionals because it relates to multiple procedures performed but what many medical coders miss is the fact it only applies to multiple procedures performed by physicians and imaging centers. Using this modifier can get your claim denied and cause a large delay in receiving reimbursements. Carriers already assume during a hospital stay that multiple procedures will already be performed therefore designation of the exact nature and type of services rendered by the attending physician will still suffice for hospital medical billing claims. The CPT manual designates modifier 51 (Multiple procedures) exempt codes with a “circle with a slash”

By: Kathryn Disney-Etienne, CCS-P, RT - Director of Operations
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