Radiology Coding Alert

Question: Should I use modifiers LT and RT to report bilateral 77073 to Medicare?

Michigan Subscriber

Answer: For a bilateral service, reporting 77073 (Bone length studies [orthoroentgenogram, scanogram]) without modifiers RT (Right side) and LT (Left side) is accurate coding, and payers won't pay you more if you add the modifiers than if you report 77073 without them.

Reason: The Medicare Physician Fee Schedule (MPFS) lists a bilateral indicator of "0" for 77073, which means the payment adjustment for a bilateral indicator does not apply.

The "National Physician Fee Schedule Relative Value File Calendar Year 2009" explains that if you append modifiers RT and LT (or modifier 50, Bilateral procedure) to a code with a "0" bilateral indicator, the carrier will base payment on whichever of the following is lower:

• the total actual charge for both sides

• 100 percent of a single code's fee schedule amount.