# Modifier -50



## ljgalindo (Jun 16, 2010)

Hi:

I would like to know if there is a more concrete difference between -50 and Rt and Lt?  There are some questions that refer to "both arms" and the choices could be -50 or left arm and right arm.   

By bilateral, is it considered like 2 eyes, 2 kidneys, 2 ears, 2 arms, 2 legs, 2 feet, 2 eyelids or just when they mention the word "bilateral" ?

When is the use of right and left if the injury or operation is in both?

Does AAPC has a more specific site where I can find answers to this kind of questions? If I go to the Forums and they give different answers, who is the real authority in this kind of questions?

Thank you and have a wonderful day!


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## mitchellde (Jun 16, 2010)

LT and RT are to be used for procedures performed on the left side only or the right side only of defined bilateral body parts or organs.  50 is to be used when a unilateral procedure is performed on both sides of a defined bilateral body part or organ.  If a procedure contains the word bilateral (or both sides) as a part of the descriptor then you do not use a modifier, and you cannot use its unilateral code with the 50 modifier.  Just remember that skin has no laterality so for skin procedures you cannot use LT, RT, or 50 modifiers.  
Now having said all of this some carriers like BCBS would prefer that you double line code the bilateral procedures using LT on one line and RT on the other.
If I have not confused you terribly I hope you found this helpful.


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## dballard2004 (Jun 17, 2010)

I agree with Debra.

Something else to add...the AMA states that modifier 50 should only be used if the procedure performed is a "mirror image," which means that the procedure was performed in the exact same spot on both sides of the body.  You may also want to look at the National Physician Fee Schedule Relative Value File on the CMS website.  There is a column for bilateral surgeries (Field 22) and if the number "1" is listed in that column, then CMS recognizes that procedure as bilateral.


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## ljgalindo (Jun 18, 2010)

THANK YOU  VERY MUCH !!!  This really helps


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## dballard2004 (Jun 18, 2010)

You are very welcome!  I'm glad I could help.


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