# Modifier 50, X-rays, and Medicare



## dballard2004

A basic coding question here....can anyone point to specific guidance from Medicare regarding modifier 50 and bilateral x-rays?  Does Medicare accept modifier 50 for bilateral x-rays or do we need to report modifiers LT and RT instead?  Where in the Medicare regs can I find this info, please?  Thanks


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## RebeccaWoodward*

As indicated in §20.6.2, modifier -50, while it may be used with diagnostic and * radiology* procedures as well as with surgical procedures, should be used to report bilateral procedures that are performed at the same operative session as a single line item. Modifiers RT and LT are not used when modifier -50 applies. A bilateral procedure is reported on one line using modifier -50. Modifier -50 applies to any bilateral procedure performed on both sides at the same session.

Modifier -50 (bilateral) applies to diagnostic, radiological, and surgical procedures

http://www.cms.gov/Transmittals/downloads/R442CP.pdf

Also...
Services in this category are generally radiology procedures or other diagnostic tests which are not subject to the special payment rules for other bilateral procedures. (Pages 220-221)

http://www.cms.gov/manuals/downloads/clm104c23.pdf


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## dballard2004

Very helpful.  Thanks so much!


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