Wiki Medicare bilateral reimbursement

[KMCFADYEN]

Is anyone having problems with Medicare bilateral reimbursement. Specifically, we are billing large joint injections (20610) with a 50 modifier to Palmetto GBA JII. They are supposed to reimburse at 150% but are only reimbursing for a single injection.

 

[bclements02]

Brenda

I had the same problem with a dry eye test I was billing for. The would not allow the 50 modifier. I have to bill it on two line items with the RT and LT modifier with 1 unit. Hope this helps.

 

[dwaldman]

You could get an example of a previous claim by the same carrier and have them over the phone compare it to the claim in question. They might have a system error.

 

[johnmeyer]

I've never been able to get payment for 20610-50 from any carrier here in Florida. I've always had to break them apart unto the two sides.