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pathology for bilateral tonsils

Jared Posted Thu 19th of May, 2011 17:03:06 PM

I need to find a definitive source to prove that 88304 may be billed with 2 unitis for 2 tonsils. I have found various references, but our state Medicaid program still denys. We have tried RT/LT modifiers, -50 modiiers, no modifier with 2 units (which Ibelieve is correct) and billing on two separate services with a charge message identifying the specimen as left or right tonsil. Someone please help. I had 18 of these denials just last week.

SuperCoder Answered Thu 19th of May, 2011 21:34:28 PM

Modifiers 50 as well as RT/LT do not go with CPT 88304. Please try with modifier 59.

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