Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Modifiers)
MOD Description Submission Guidelines Impact to Payment
-51 Multiple
Procedures
-52 Reduced
Services
-53 Discontinued
Procedure
11-6
When more than one service is performed
during the same operative session, the –51
modifier may be appended to all secondary
surgical procedures.
It is not necessary to append the –51
modifier to “add on” or to exempt codes.
Applicable code edits will be applied to
services submitted.
Append the –52 modifier to indicate that a
service or procedure is partially reduced or
eliminated at the physician’s discretion.
This provides a means of reporting reduced
services without disturbing the
identification of the basic service.
Append –53 when the physician elects to
terminate the procedure
The -51 modifier
itself does not affect
payment. Multiple
surgical payment is
based on whether the
surgical procedure
may be subject to a
multiple surgery.
Then the reduction
would be based on the
allowed amount. The
lowest valued
procedure(s) will
have the multiple
surgical reduction
applied. When
covered, payment is
made at 50% of the
allowed amount for
all allowable
secondary procedures.
The normal full
charge billed or a
reduced charge for the
procedure may be
submitted. Blue Cross
will pay the lesser of
either 90% of the
physician fee
schedule allowance
for the procedure or
the charge submitted.
The normal full
charge or reduced
charge should be
submitted.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (10/05/11)