Tips: Billing for Multiple Surgical Procedures

By Nina Youngstrom

Here are tips to help with compliant use of modifiers 51 and 59 from Betsy Nicoletti, a consultant based in Massachusetts. Contact her at betsy@betsynicoletti.com.

Billing for Multiple Surgical Procedures

July 27, 2023

Copyright 2023, Betsy Nicoletti

When billing for multiple procedures on the same day, use this step by step procedure to determine if you should bill for more than one procedure, and if so, if you should use modifier 51 or modifier 59. It is critical to have access to National Correct Coding Initiative (NCCI) edits in your software program. The NCCI edits are developed by Medicare. They include services that are mutually exclusive, medically unlikely edits, and procedure-to-procedure edits, commonly called bundling edits.

In some groups, the coder performs all of the steps below. The responsibilities indicated here are my opinion, and not law, regulation or national policy.

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