Radiology Coding Alert

Question: Our office performed bilateral duplex scans of the extremity veins and we reported 93970-50, but we didn’t collect for the bilateral procedure. Our office manager said we should have instead reported 93970 with modifiers RT and LT appended. Who is right?

Codify Subscriber

Answer: Unfortunately, both of you are incorrect. You should report the bilateral study code once without any modifiers appended. You’ll report one unit of CPT^® code 93970 (Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study) with no modifiers and no additional units. The code is inherently bilateral and therefore covers both extremities in the value assigned to it.

Medicare carriers reimburse practices about $200 for one unit of 93970 based on the 2017 Medicare Physician Fee Schedule. You won’t recoup extra reimbursement by appending modifier 50 (Bilateral procedure) or the LT (Left side) and RT (Right side) modifiers. Not only will you not collect more, but your payer may flag you for coding inappropriately if you append these modifiers to a bilateral code.