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x ray billing

Melisa Posted Tue 10th of May, 2011 17:21:48 PM

If you perform a bilateral x ray of the knee 73560 is this 2 units or would you use the modifier 50 thanks

SuperCoder Answered Tue 10th of May, 2011 17:52:14 PM

It vary from carrier to carrier. Some payers require procedure code only once with "2" in the units of service box on the claim form and some require RT&LT with two separate lines. So I would suggest to work with your payers to determine correct method of billing. If you are billing for medicare, then use two separate lines with RT&LT as Medicare prefer 2 separate lines with RT and LT only.

SuperCoder Answered Tue 10th of May, 2011 19:21:47 PM

If you are performing Bilateral x-ray of Knee, you have to consider two categories of codes.
1st: 73560-73564: For these category of codes you can use "RT" or "LT" modifiers.
2nd: 73565: It is itself a bilateral code. So, modifier like "RT" or "LT" or mod.50 can't be used.

SuperCoder Answered Wed 11th of May, 2011 05:47:31 AM

Yes.. I agree with Sanjit

SuperCoder Answered Wed 11th of May, 2011 10:42:07 AM

Now, the tricky situation comes if there is a situation that tells you to code from both the categories of codes. The guidelines have changed over the years. If such a problem crops up, plz post your question with details. I would like to answer that with more elaboration.

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