I have a question concerning the use of modifier 51 in burn surgery and whether carriers are allowed to reduce the RVU by 50% when they apply that modifier. I swear I read somewhere that a 51 modifier no longer means that the RVU can be discounted.
CPT guidelines state that modifier 51 (multiple procedures) is appended to a secondary – not the primary – stand-alone CPT code. Many payors apply a 50% multiple procedure payment reduction even though some payors do not require use of the modifier. This reduction is acceptable because there is overlapping pre- and post-operative global period activity when more than one stand-alone CPT code is billed.
Modifier 51 is not appended to add-on codes (e.g., additional sq cm split thickness skin graft codes) because the value for the add-on code is already reduced to account for the fact that there is no pre- or post-operative global period to that code. Payors should not reduce add-on codes by 50%.