cwilson3333
Expert
Re: submitting J codes
I recently got a physcian tip sheet stating that Medicare is denying claims on some of the bilateral procedures being submitted on 2 lines [RT and LT]
CMS rules now state for bilateral services should be reported on one claim line with the Modifier "50" and a unit of service as 1, to prevent these denials.
I'm also told by another biller that "J" codes do not require the modifer 50.
So, can anyone give me some input on this matter.
For example, when our patient gets bilateral Hyalgan injections in the office, this is how my claim has been going out:
J7321 RT
20610 RT
J7321 LT
20610 LT
I recently got a physcian tip sheet stating that Medicare is denying claims on some of the bilateral procedures being submitted on 2 lines [RT and LT]
CMS rules now state for bilateral services should be reported on one claim line with the Modifier "50" and a unit of service as 1, to prevent these denials.
I'm also told by another biller that "J" codes do not require the modifer 50.
So, can anyone give me some input on this matter.
For example, when our patient gets bilateral Hyalgan injections in the office, this is how my claim has been going out:
J7321 RT
20610 RT
J7321 LT
20610 LT