Wiki Blepharoplasty with modifier?

[ridenut]

I recently started working for a plastic surgeon and today was billing out a procedure where both eyes had a Blepharoplasty done. The suergon wants to bill 2 CPT codes but I think we should use one code with a modifier -50. I was told that the surgeon uses 2 codes because he has a higher reimbursement. The CPT book indicates to use the modifier - 50. Can someone help me and give me some talking points. thanks!!

 

[drakena74]

I recently started working for a plastic surgeon and today was billing out a procedure where both eyes had a Blepharoplasty done. The suergon wants to bill 2 CPT codes but I think we should use one code with a modifier -50. I was told that the surgeon uses 2 codes because he has a higher reimbursement but my reaction was that he might be getting a higher paycheck but also commiting fraud. The CPT book indicates to use the modifier - 50. Can someone help me and give me some talking points. thanks!!

You can do either one. You can bill two lines using mod. -LT & -RT or one code using mod. -50. Check the insurance billing guidelines to see how they prefer it to be billed.

 

[ridenut]

Thanks!!