Billing Multiple Procedures..

our physician has performed the following procedures on the same DoS.

31628, 31627, 31624 and 31623 (wanna bill in the same sequence)

I'm confused whether to use modifier 51 for procedures other than primary or not.

Anybody can help me out.

Thanks in advance,
Ravi

re: Billing Multiple Procedures..

If it is a Medicare claim, you typically don't need modifier 51. Any multiple procedure adjustments would be made automatically with the codes billed together.

re: Billing Multiple Procedures..

Many thanks for your help.

And, the patient is covered by a private insurance.. So, should we use Modifier 51?
One more thing is that I think, the sequence would be 31628, 31624, 31623 and 31627 based on the RVU (higher to lower). Is that correct?

Please advise.

re: Billing Multiple Procedures..

There are no CCI edits that prohibit the codes from being billed together. It appears mod 51 would be appropriate in this case. Some payers actually do not require mod 51 and automatically apply the multiple procedure payment reduction. My sincere hope is that with the transition to ICD-10 and greater specificity in diagnosis codes, that we will do away most of the modifiers altogether.

Oh and yes...I always try to list procedures in RVU order, although many do not - ultimately this can impact your payments.