ADD-ON CODES: Certain codes, by the nature of their description and the unit values assigned, have already
been reduced, as they are not to be billed as primary procedures. For a complete list of the codes which are
considered to be add-on codes, refer to the appropriate appendix found within the most recent publication of the
AMA Current Procedural Terminology (CPT).
CODES THAT ARE NOT CLASSIFIED AS ADD-ON CODES BUT ARE EXEMPT FROM THE MULTIPLE
PROCEDURE RULE / MODIFIER -51: For a complete list of the codes which fall into this category, refer to the
appropriate appendix found within the most recent publication of the AMA Current Procedural Terminology
(CPT).
CODES WHICH INCLUDE CONSCIOUS SEDATION: Certain codes include conscious sedation as an inherent
part of providing the procedure. For a complete list of codes that include conscious sedation, refer to the
appropriate appendix that is found within the most recent publication of the AMA Current Procedural
Terminology (CPT).
FOLLOW-UP OR AFTERCARE: Follow-up care for therapeutic surgical procedures includes all normal
postoperative care, that care which is usually a part of the surgical service. Complications, exacerbations,
recurrence of the condition, or the presence of other diseases or injuries requiring additional services concurrent
with the procedure may warrant additional charges. If such separate charges are made, explain by report with an
adequate description. When an additional surgical procedure is performed during any follow-up care and is
related to the previously performed procedure but is not an intrinsic part of the latter, the additional procedure will
be paid at one-half the maximum allowable payment.
