Modifier Coding Alert
Know CPT® Rules to Nail Bilateral Claims
Question: Our physician recently performed a diagnostic thoracentesis for a patient with a pleural effusion at a local hospital. Notes indicate that the patient was only scheduled for treatment on a right-sided pleural effusion, but the physician discovered fluid on the left side of the pleural cavity as well. Notes indicate that the physician used fluoroscopic guidance for both procedures. Can I report this as a bilateral procedure?
Nebraska Subscriber
Answer: Yes, you can. On the claim, report 32555 (Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance) with modifier 50 (Bilateral procedure) appended to show that the physician had to perform thoracentesis on both sides of the patient’s pleural cavity.
Good idea: Check your payer’s status on the use of modifiers LT (Left side) and RT (Right side). Some of them might want you to report 32555-RT and 32555-LT-50 to prove the bilaterality of the procedure.
Related Articles
Modifier Coding Alert
- Site Modifiers:
Work Full-Time With F/T Modifiers, and Quit Getting Denials
Here’s why you should use these modifiers whenever the insurer requires them. There’s no tiptoeing [...] - CPT® 2016:
Learn New Prolonged Services Codes, Master 'Team' Coding
Modifier 25 might be the key to your claims with these new/revised codes. When CPT® [...] - Modifier Madness:
Look to 66 In 'Team' Situations
Remember, every surgical team member has to use modifier 66. There are several modifiers in [...] - Reader Question:
Use Modifier 27 On Multiple Outpatient E/Ms
Question: I code outpatient hospital services for a multispecialty physician clinic that treats cancer patients. When [...] - Reader Question:
Prove Separate Services; Append Modifier to E/M During Well-Woman Visit
Question: An established, high-risk 72-year-old Medicare patient presents to the office for her annual well-woman exam. [...] - Reader Question:
Know CPT® Rules to Nail Bilateral Claims
Question: Our physician recently performed a diagnostic thoracentesis for a patient with a pleural effusion at [...] - Reader Question:
Make QW Part of All Your CLIA-Waived Claims
Question: Our physician recently performed a cardiovascular blood screening for an established Medicare patient. Our practice [...] - You Be the Expert:
Coding E/M-Nosebleed Repair Combos
Question: A 19-year-old established patient reported to our family physician (FP) with a nosebleed that she [...]
