20610 - 50, x 1 unit
The RBRVU Fee Schedule by MCR gives you specific directions on how to bill procedures bilaterally. It has to do with the status indicator #, in this I instance the 20610 is a 1. Meaning Medicare wants it billed on 1 line with a modifier 50. The computer will multiply the base unit times 150% and pay that amount. You do not need to adjust your fee and double it as some coders do. It's all done for you.
Status indicator 1 = multiple procedure reduction rules apply
- 1 line, modifier 50
Status indicator 2= both procedures will pay 100%
- bill either -50 or RT LT (check your MUE edit, only use RT-LT is 2 units are allowed)
Status indicator 3= Bilateral procedures not applicable
Side note: I have found bilateral medical policies on most major carriers, BCBS, Aetna, United that all follow the same methodology. Check your carrier for specific rules. Because the MUE edits were changed and many CPT codes were reduced to 1 unit, the 2 line = RT, LT and/or modifier 50 on the 2nd line coding rule has almost been eliminated.