Wiki Total mastectomy Bi with Bilateral first-stage breast reconstruction with insertion of tissue expanders and use of acellular dermal matrix bilaterally

[carol52]

Hello, this is a charge for Blue Cross
I coded this as below but my question is should the acellular dermal matrix bilateral +15777 have a 50 modifier added to it.
I am being told by the billing dept to add modifiers in this sequence
19303 LT
19303 50, RT
38900
38525 LT
19357 LT
19357 50. RT
+15777 Needs 50 modifier or no modifier ??
Thanks
Carol

 

[NPSDEB]

Look at the guidelines for 15777. You do not use 50 modifier when it is related to breast procedures. You report it twice with RT & LT modifiers.

 

[such78]

15777 - for bilateral procedure, report 15777 two times. do not use mod 50 in conjunction with 15777. Since it is an add-on code, should not use mod for it.

 

[apoland]

15777 has a MUE of 1, we are getting denials when billing multiple lines or multiple units of it. It seems like the guidelines contradict themselves on this code being 50 modifier exempt, but allowed for bilateral surgery. Any information on this?