Wiki Bilateral Hernia's

Create Wiki
Medicare guidelines state to look at the National Fee Schedule and in Column Z if the Bilateral Surgery Indicator = 1 use a modifier 50 on one line with one unit of service. A bilateral Surgery Indicator = 2 indicates that the procedure is not eligible for bilateral modifier because this code already based on services being performed as bilateral. Bilateral Surgery Indicator = 3 When a right and left service were actually rendered please submit the claim with a 50 modifier on one line with one unit of service (this one is allowed at 200%).
The hernia repair does have a 1 in Column Z of National Fee Schedule. Go to your Medicare website and look at the National Fee Schedule not the State.
I hope this helps. I got my information from Cahaba GBA and it is titled How to bill for Services with Bilateral Indicators.
Teresa
 
Medicare wants you to code bilateral as 1 line 1 unit with a modifier 50 and override your charge so that it doubles
 
You must log in or register to reply here.
Top