# ASC Bilateral Codes



## bella2 (Oct 27, 2009)

Hi,

 I'm looking for advice on billing out bilateral procedures in an ASC setting,in
Florida, there seems to be so much confusion on the issue, I would really love to hear some opinions from other coders on this issue.

Thanks in advance for all responses.


----------



## mitchellde (Oct 27, 2009)

You bill one line item with a 50 modifier and one unit of service and the single code charge.


----------



## bella2 (Oct 27, 2009)

Hi Debra,

Not to sound foolish but just to make sure I understand it properly,
if patient had a bilateral arthroscropic rotator cuff repair, I should just report
29827-50 ???

Thanks for your help,

Bella


----------



## mitchellde (Oct 27, 2009)

for facility coding I have always done it that way.  Even for ASC.  However in the physician world some carriers would have them do it as:
29872 LT
29872 RT


----------



## ASC CODER (Oct 27, 2009)

Medicare wants two line items with Lt and Rt.


----------



## mbort (Oct 27, 2009)

I agree with lgentry.

I follow Medicare guidelines for all carriers to avoid confusion and do not have any problems with any payors.

Per Medicare, the 50 Modifier is not valid in an ASC and you must use separate lines with RT/LT.


----------



## mitchellde (Oct 27, 2009)

Is it possible this is a regional issue with Medicare?  Because I have just the opposite being stated here for Medicare as in do not use LT RT for bilateral.  Isn't our job FUN!


----------



## mbort (Oct 28, 2009)

Hmm I guess it could be, but here is the MLM from CMS directly

http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0742.pdf


----------



## bella2 (Oct 28, 2009)

Thanks Mary, you're the best


----------



## mad_one80 (Oct 28, 2009)

mitchellde said:


> Is it possible this is a regional issue with Medicare?  Because I have just the opposite being stated here for Medicare as in do not use LT RT for bilateral.  Isn't our job FUN!



i was told (in CA) that Mcare considers LT/RT as informational modifiers so in bilateral cases, i bill one line with the code and the 2nd line with -59 modifiers for both ASC and professional.  All other insurances i use the -50 modifier or LT/RT.


----------



## tgutierrez (Nov 3, 2009)

I'm in Arizona and for Medicare we bill RT/LT. But for other payers there is no one answer. Some payers also want RT/LT, some want one line with 50 modifier and one unit and I even have one that wants one line with 50 modifier and two units.

I go with what the payer wants. A lot less claim follow up that way.


----------

