CPT Modifier 51 exempt codes

Modifier 51 exempt codes are typically adjunctive or reported with other procedures. The amount of pre- and postservice time associated with these codes is minimal, and use of modifier 51 to signify a value reduction would be inappropriate. For information on service time and work relative values, please refer to the AMA publication Medicare RBRVS: The Physicians’ Guide. Multiple codes [eg, 20660, Application of cranial tongs, caliper, or stereotac- tic frame, including removal (separate procedure)] were
removed from the list of modifier 51 exempt codes found in Appendix E of CPT 2008.

The bone graft for spinal surgery codes 20930, 20931, and 20936-20938 have been removed from the modifier 51 exemption list (Appendix E), assigned add-on code status, and relocated to the add-on code list (Appendix D of the CPT codebook).

The CPT Editorial Panel supported the AMA’s RVS Update Committee (RUC) finding that codes 20930-20938 include more characteristics associated with add-on codes rather than modifier 51 exempt codes.
Add-on codes are always performed with a defined base code or codes, whereas modifier 51 exempt codes are not always adjunctive; and the base codes associated with modifier 51 exempt codes are either too extensive to list or not easily defined. Both add-on and modifier 51 exempt codes are similar in that neither should be subject to mul-tiple procedure reductions.

8 comments:


  1. Great Article. its is very very helpful for all of us and I never get bored while reading your article because, they are becomes a more and more interesting from the starting lines until the end.

    CPC training Hyderabad

    ReplyDelete
  2. Nice and informative article...
    Thanks for sharing with us!!
    Medical Coding Jobs in UAE

    ReplyDelete

  3. nice information..thanks for providing valuable information..
    Medical coding training

    ReplyDelete
  4. nice tutorials..thanks for sharing such a wonderful information..keep update with your blogs.

    Medical Coding CPC Certification Hyderabad

    ReplyDelete
  5. A great content material as well as great layout. Your website deserves all of the positive feedback it’s been getting. I will be back soon for further quality contents. https://www.abi-med.com/product/2

    ReplyDelete