Ophthalmology and Optometry Coding Alert
Bilateral Modifier Rules Can Get Confusing
Question: Thank you for your article last month about bilateral coding. I have a follow-up question. We have one workers’ compensation payer that asks for us to report both the modifier 50 and the modifiers LT and RT. This doesn’t seem like correct coding. Can we refuse? Codify Subscriber Answer: Probably not. In most cases, payers will ask you to report either modifier 50 (Bilateral procedure) on one code, or to use the LT (Left side) modifier on one and the RT (Right side) modifier on the other. However, workers’ compensation payers are within their rights to create their own preferences, and if your insurer refuses to pay a bilateral service without using all three modifiers (50, LT, RT), then you should follow their directive and use them all.
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