1. Tara Purdy
   Posted 3 months ago #
   

   aetna ins continues to deny this code when billed bilat even with documentation and information from the academy. can you please provide stronger info for us to submit to see how they can reconsider?
   Tara

2. SuperCoder
   Posted 3 months ago #
   

   The modifier indicator for modifier 50 for the CPT 30930 is "1". The Modifier inidicator "1" implies that 150% bilateral payment adjustment applies. Payment for bilateral procedure (e.g., 50, RT/LT, 2 units) is lower of (a) actual charge for both sides or (b) 150% of fee schedule amount for single code. Apply bilateral adjustment before multiple procedure rules.
   For proof: Click on the link http://www.supercoder.com/code-lookup/cpt/codes/?code=30930
   150% bilateral payment adjustment applies. Payment for bilateral procedure (e.g., 50, RT/LT, 2 units) is lower of (a) actual charge for both sides or (b) 150% of fee schedule amount for single code. Apply bilateral adjustment before multiple procedure rules. "Fee Schedule" and scroll donw to Modifier Guidelines and click on "modifier rules" of modifier 50.

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