# 64445, 64447 and 76942 modifiers



## cschoocpc (Dec 11, 2014)

Modifiers 50 and 51 always seem to throw me.  I need confirmation that I am using them correctly. Would like some feedback on the following please:

During bilateral ankle scopes, surgeon requested postop pain blocks using ultrasound guidance.  

Anes did a total of 4 blocks (Popliteal 64445 and Saphenous 64447 on each foot).  He used ultrasound guidance (76942) on all four blocks.


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## Michele Hannon (Dec 12, 2014)

-50 is your bilateral modifier

76942 can only be reported once


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## Amy Pritchett (Dec 15, 2014)

For this procedure, if the physician performed (4) blocks, two in each foot, then the guidelines for using 50 and 51 are below:

50- for bilateral procedure only
51- for more than 3 procedures performed on the same date of service. 

Are you sure that you are not questioning (59) modifier and not (50) modifier??

Also, the 76942 can only be reported once per session.

Hope this helps


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## LisaAlonso23 (Jan 1, 2015)

i would code it this way if you're coding for the Anestheiologist:

64445-50 -59
64447-50 -59
76942-26 (-26 if the Anesthesiologist doesn't own the equipment)


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## shariblove (Feb 27, 2015)

Would you need a 59 on the 76942 also Lisa?

Thanks!
Shari


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## karras (Feb 28, 2015)

Make sure you review the guidelines for using that modifier.  We have found it very difficult to apply the 59 modifier in the situation you've described.  We have found that a lot of carriers are refusing to pay for the guidance because they see it as an inherit part of procedure.  I checked with a few of my physicians and that is how they viewed it also.  

Kim


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