Wiki 22612 - Tricare denial....

[tmarugg]

I've gotten a couple of denials from Tricare when we bill 22612. The denial states "inherent bilateral procedure with units greater than one."

We are only billing 1 unit, so that takes that out of the equation.

So does 22612 require an LT, RT, or 50 modifier?

Tricare is the only payer that I am having an issue with.

Thanks in advance!

 

[KMCFADYEN]

22612 has no 150% bilateral payment boost and MUE of 1.
22612 is billed with no modifiers and can only be billed one time per session.

 

[tmarugg]

Thank you.