tci Medicare Compliance & Reimbursement - 2023 Issue Q1

Part B Coding Coach: Know the Facts on Modifier 50

Warning: Payer policies may differ, so review the fine print. There are a plethora of codes in CPT® that describe procedures and services involving anatomic structures. But do you know when you should append modifier 50 (Bilateral procedure) to those codes? And do you know when you should use Level II HCPCS modifiers LT (Left side) or RT (Right side) instead of, or in addition to, modifier 50? Payer guidance regarding these anatomic procedure modifiers is all over the map. So, here are the answers to a number of your frequently asked questions about modifiers 50, LT, and RT...

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