Wiki modifier LT, RT, and 50

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akaeb

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We have encounters where a procedure is done to both the left and right side. Are we okay to use LT on one charge and RT and 50 on the other charge? Or should 59 be used instead of 50? Does it depend on the payer?

Thank You!
 
akaeb said:
We have encounters where a procedure is done to both the left and right side. Are we okay to use LT on one charge and RT and 50 on the other charge? Or should 59 be used instead of 50? Does it depend on the payer?

Thank You!
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It will depend on the payer and the CPT code. Can you give examples of which codes you are trying to bill bilaterally?
 
akaeb said:
27447 LT, 27447 RT this is how it originally went out for Medicare
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That code has bilateral indicator of 1, which means:

"If the indicator is "1," the 150 percent payment adjustment for bilateral procedures applies. If code is billed with the bilateral modifier or is reported twice on the same day by any other means (e.g., with RT and LT modifiers or with a 2 in the units field), base payment for these codes when reported as bilateral procedures on the lower of: (a) the total actual charge for both sides or (b) 150 percent of the fee schedule amount for a single code. If code is reported as a bilateral procedure and is reported with other procedure codes on the same day, apply the bilateral adjustment before applying any applicable multiple procedure rules."

You should be able to bill on 1 line with modifier 50. What does the denial say?
 
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