ellis3350
Guru
Hello,
I'm curious if anyone could explain the Bilateral 50 modifier coding guideline to me. For example CPT 75710,26. I see in Codify the RT/LT are listed as allowable modifiers however I had an audit and was told not to use the laterality modifier due to the reason below. If I'm not mistaken, isn't the reason below meaning not to use both RT and LT on the same line? Any help is appreciated.
0 = 150% payment adjustment for bilateral procedures does not apply. If procedure is reported with modifier -50 or with modifiers RT and LT, base the payment for the two sides on the lower of: (a) the total actual charge for both sides or (b) 100% of the fee schedule amount for a single code.
I'm curious if anyone could explain the Bilateral 50 modifier coding guideline to me. For example CPT 75710,26. I see in Codify the RT/LT are listed as allowable modifiers however I had an audit and was told not to use the laterality modifier due to the reason below. If I'm not mistaken, isn't the reason below meaning not to use both RT and LT on the same line? Any help is appreciated.
0 = 150% payment adjustment for bilateral procedures does not apply. If procedure is reported with modifier -50 or with modifiers RT and LT, base the payment for the two sides on the lower of: (a) the total actual charge for both sides or (b) 100% of the fee schedule amount for a single code.