Wiki mod 50 or LT and RT for cast application

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micki127

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Derry
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Hello,

I need help please..... Can you tell me what is appropriate for bilateral distal radius fractures. I need to bill out bilateral cast applications (CPT 29075). Should I add mod 50 or use left and right with the 29075.

Thank you in advance.
 
This is a carrier preference so you will have to indicate who they are for accurate information.

Medicare has a MUE limit of one, so 1 line, modifier 50 would be the correct route.

BCBS of Alabama wants 2 lines, and modifier 50 on the second line.
 
Thank You

The carrier would be United Health Care. So if you happen to know there preference that would be a huge help.

Thank you in advance.
 
Not all BCBS wants two lines using the 50 on the second line, I had one client do this in NC and they paid for 3, So in that state BCBS wants 2 lines using RT on one and LT on the other. It will vary however most of the time it is one line with the 50 Modifier. When in doubt check with your carrier. With ICD-10 CM this may change with many carriers as the dx codes can say right left and even with some bilateral diagnosis.
 
I completely agree with Debra. Each carrier is going to be different.

United follows Medicare rules for everything (Global package/status indicators/modifier rules). You will need to know how to look up the status indicators for procedures to understand what modifiers to use. I have a cheat sheet that summarizes it for you, but you will have to email me privately on here before I can send it as I will not monitor this posting.

Google: United Healthcare Bilateral Procedures Policy 2014R0023A
 
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