AMA CPT® Assistant - 2023 Issue 7 (July)

Reporting CPT Modifiers 51 and 59 (July 2023)

July 2023 pages 1-10 Reporting CPT Modifiers 51 and 59 A modifier is used to report or indicate that a performed service or procedure was altered by some specific circumstance and noted by the physician or other qualified health care professional (QHP) but not changed in its definition or code. Modifiers enable health care professionals to effectively respond to payment policy requirements established by Medicare and other third-party payers, and their definitions are listed in Appendix A of the Current Procedural Terminology (CPT®) code set. This article discusses and provides examples of the appropriate use of modifier 51...

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CPT® Assistant content is the official source for CPT® coding guidance. It is an instrumental tool when appealing insurance denials and validating coding to auditors. Monthly issues and an extensive archive provide comprehensive guidance on proper CPT® coding for past, present and upcoming code set releases. Archives date back to 1990 for historical use of codes, changes, rationales, coding tips and trends in the industry.

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