Orthopedic Coding Alert

Question: Can we use modifier -50 (Bilateral procedure) with x-ray codes such as 73560 (Radiologic examination, knee; two views) or 73110 (Radiologic examination, wrist; complete, minimum of three views)? We have tried using this modifier with one unit of each code, but Medicare either denies the second x-ray as a duplicate service or pays it at 50 percent.

Missouri Subscriber

Answer: According to CPT Assistant, "It is not appropriate to append modifier -50 to the radiology procedure (70000 series) codes, as there are other modifiers to designate separately identifiable procedures (e.g., modifier -59, Distinct procedural service)."

Generally when coding x-rays, you should report each unit on a separate line item with the site modifiers, -RT for the right side and -LT for the left. Therefore, a claim for two x-ray views of the femur on each leg should be reported as follows:

73560-LT

73560-RT.