# Medicare modifier -50 & -59 payments



## Runner88 (Aug 16, 2013)

For an ASC: Where can I find the new Medicare policy on the billing of bilateral procedures and multiple same procedures? We have been billing per occurence for each ex.:

1) 69436
2) 69436-50

1) 64483
2) 64484
3) 64484-59

Medicare has not been paying 2nd/3rd line. I called local Medicare carrier and was told to bill Bilateral on 1 line with the modifier only 1 unit. I did this as well and the payment is still not right. I am on the verge of pulling my hair out!  Thanks!


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## shenell333@yahoo.com (Aug 16, 2013)

http://www.cahabagba.com/news/changes-to-modifier-59-important-notice/

I hope this helps!


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## miracle01 (Aug 24, 2013)

*modifier 59*

When billing transforaminal steroid injection multiple levels you should use the RT/LT modifier.  Remember  when using an add-on code such as 64484 you do not use modifier 59 as it cannot be used without the parent code 64483.  example:

64483 RT
64484 RT
or
64483 RT
64484 LT
64484 LT

bilateral bill it like this:  

64483 RT
64483 LT

I'm not sure how many levels of injections Medicare will pay for besides 2.


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