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Modifier on bi-lateral procedure

Chery Posted Wed 10th of June, 2015 11:39:13 AM

What modifier would I use on bi-lateral avastin injections done on same day (67028 w/J9035 OD and 67028 w/J9036 OS)?

SuperCoder Answered Thu 11th of June, 2015 02:40:32 AM

Well, J9036 not a code (I guess this is a typo error). J9035-OD and OS correct pattern. And modifier 50 is appropriate with CPT 67028 for bilateral procedure.

SuperCoder Answered Thu 11th of June, 2015 03:41:14 AM

Check with the payer's policy to know whether you need to bill 67028 in a single line item or in 2 lines. If in a single line, bill 67028 - 50 (modifier). If 2 line items are allowed, bill 67028 - LT, 67028 - RT in 2 lines and then bill j9035 - OD and J9035 - OS .

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