CPT modifier
Modifier 51: Multiple procedures
Modifier 51 is a CPT modifier. In plain terms: More than one procedure was done by the same provider in the same session.
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- Modifier
- 51
- Type
- CPT (Level I) modifier, maintained by the AMA
- Plain description
- More than one procedure was done by the same provider in the same session.
- How it is used
- Payers reduce payment for the second and later procedures. Medicare applies its multiple procedure rules on its own, so many contractors do not need 51 on the claim.
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
The CPT descriptor is AMA copyright and is not shown here. The description above is written by Rivvi. Read the CMS guidance linked above for Medicare's rules.
Multiple procedures and modifiers
Related modifiers
Related pages
- All CPT and HCPCS modifiersA to Z list
- CMS-1500 claim formModifiers go in item 24D
- Denial code CO-4Modifier missing or does not fit the code
- Denial code CO-182Modifier invalid on the date of service
- Denial code CO-97Included in another service
- Denial code CO-236Procedure or modifier pair not compatible
- HCPCS Level II code lookup
- Denial and remark codes
Questions
What does modifier 51 mean?
Modifier 51 is a CPT modifier. In plain terms: More than one procedure was done by the same provider in the same session.
Is modifier 51 a CPT or a HCPCS modifier?
51 is a CPT (Level I) modifier. The AMA maintains CPT modifiers. Two-character codes with a letter, such as GT or XU, are HCPCS Level II modifiers from CMS.
Where does modifier 51 go on a claim?
On the CMS-1500 it goes in item 24D next to the procedure code. Each line holds up to four modifiers. On an 837P it goes in SV101-3 to SV101-6.
When is modifier 51 used?
Payers reduce payment for the second and later procedures. Medicare applies its multiple procedure rules on its own, so many contractors do not need 51 on the claim.
What denial comes back when a modifier is wrong?
A missing or mismatched modifier often comes back as CARC 4. A modifier that was not valid on the date of service comes back as CARC 182. A bundling edit the modifier should have bypassed comes back as CARC 97 or 236.