# Bilateral Procedure Question-I know this



## lrountree (Mar 1, 2010)

I know this is a very basic question but I can't get a straight answer... is there one way that is accepted by Medicare, Medicare replacements, and commertial insurances to bill bilateral procedures? Every site I look at says something different. 
some examples are:
92135  -50, 2 units, single charge $
or
92135 -50, 1 unit, double charge $
or
92135-LT, single charge
92135-RT, single charge

Are any of these ways universal???
HELP!


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## jthweatt (Mar 2, 2010)

It just depends on your carrier.  Here in Alabama, Medicare wants xxxxx-50 with one unit and double price; Alabama Medicaid wants xxxxx-LT X 1 and xxxxx-RT X 1; most commercial carriers prefer xxxxx X 1 and xxxxx-50 X 1.  And since they are paying they get to call the shots.  

Have fun.

Jerri, CPC


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## nidhim (Mar 2, 2010)

*Bilateral Procedure Question*

According to Medicare, the application of the bilateral payment rule is dependent on the bilateral indicator on the Medciare Fee Schedule Database MFSDB).The bilateral payment adjustment does not apply to a procedure with 0,2 or 3 indicator and CPT 92135 falls under indicator 3. Do not use modifier -50, instead use RT, LT- on one line with (2) in unit column.

Hope this helps.

Nidhi M., CPC
www.symbiosisbilling.com


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## lrountree (Mar 3, 2010)

Thank you sooo much! But where do you find that information? (MFSDB)? Thanks again!


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## RebeccaWoodward* (Mar 3, 2010)

http://www.cms.hhs.gov/pfslookup/02_PFSsearch.asp

Click on *payment policy indicators *and enter your information.  This link provides the status indicator.  The link below translates the definitions of those indicators.  


http://www.cms.hhs.gov/PhysicianFee...scending&itemID=CMS1223394&intNumPerPage=2000

Under downloads, click RVU09C

Open the PDF and go to pages 10-11 for bilateral.


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## lrountree (Mar 3, 2010)

Perfect! Thanks!! This helps tremendously!


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## pammalou (Mar 4, 2010)

This information is very helpful for all to review on a periodic basis for a refresher.  We get so used to going through the motions, that it is good to reveiw and refresh.  Thank you.


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## Joan Marrs (Mar 19, 2010)

*Bilateral procedure question*

I have found this document helpful:
http://www.lamedicare.com/provider/datanaly/modflow/MODFLW2000.pdf


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