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MPR policy

Apurva Posted Fri 17th of May, 2019 05:21:58 AM
Per Multiple reduction procedure policy MODIFIER 51 needs to be appended first followed by 59
SuperCoder Answered Mon 20th of May, 2019 09:05:10 AM

Medicare doesn’t recommend reporting Modifier 51 on the claims. Some private payers also do not allow modifier 51. Moreover, please let us know which place of service (POS) you are billing for?

 

Thanks

Apurva Posted Tue 21st of May, 2019 00:29:03 AM
We are billing for POS 24 . We are receiving denials for NHP Medicare insurance for Multiple reduction procedure policy. Hence once denial received we are rebilling with 45385 and 45380-51-59.
SuperCoder Answered Tue 21st of May, 2019 05:54:48 AM

If you are billing for POS 24 (ASC), then modifier 51 cannot be reported since ASC does not allow the use of modifier 51. So, please remove modifier 51 and bill with modifier 59 only.

 

Please feel free to write if you have any question.

 

Thanks

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