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Using the modifier 50

Leslie Posted Tue 05th of April, 2011 13:08:43 PM

When a bilateral procedure is done, is it correct to bill the procedure once with a 50 modifier? There has been a person telling me that you should list the line item 1st without the modifier then list the line item again with the modifier 50 which doesn't make any sense to me. The code we are dealing with is 36475 done bilateraly.

SuperCoder Answered Tue 05th of April, 2011 14:34:23 PM

This is a case where you should prefer billing 1st line with RT and 2nd line with LT modifier.

Regarding concept of modifier 50 with any other surgical procedure where modifier 50 is applicable:
1st method: Only one line item with modifier 50

2nd method: 1st line item: only CPT
2nd line itme: CPT with modifier 50
Since both 1st method and 2nd method both have same meaning, so it is preferrable to follow 1st method. Because, in both the cases the charges to be reimbursed is 150% of the billed CPT's fee value.

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