Otolaryngology Coding Alert

The number in column S of the Fee Schedule indicates whether a code can be billed bilaterally.
  
If the procedure cannot or should not be performed bilaterally, a 0 appears in column S.
  
If the procedure can be performed bilaterally and there are distinct codes for the procedure being performed unilaterally and bilaterally, a 0 appears in column S for the unilateral code.
  
If the procedure shows a 1 in column S and is reported with modifier -50 (bilateral procedure) or by any other means such as with modifiers -RT or -LT to indicate right side or left side, or with a 2 in the units field of HCFA form 1500 there is a 150 percent payment adjustment.
  
If a bilateral procedure is performed during the same session as other procedures or services, the bilateral adjustment should be made before multiple procedures are considered.
  
A 2 in column S signifies that no fee adjustment should be made because the RVUs for the code assume that a bilateral procedure was performed. This can occur when the code descriptor specifically states that the procedure is bilateral, when the code descriptor states that the procedure may be performed either unilaterally or bilaterally, or when the procedure is usually performed as a bilateral procedure.
  
If the procedure cannot be classified bilateral, a 9 appears in column S.