Medicare Compliance & Reimbursement - 2018 Issue 7
Reader Question: Refrain from Modifier Use on Bilateral Indicator 2 Codes
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Article Overview
This article addresses a coding question about mammography and breast tomosynthesis reporting, with emphasis on laterality and Medicare bilateral indicator concepts. It is written for coders and billing professionals who need to understand how a code’s status in the fee schedule affects modifier use and claim reporting. The discussion stays focused on general guidance tied to the code set, payer references, and modifier handling.
Why This Topic Matters
Laterality and bilateral indicator rules can affect how related imaging services are reported and processed. Understanding the general framework helps coders evaluate whether a service requires additional modifier reporting and how payer guidance may apply.
Article Sections
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Question
Introduces a reader inquiry about reporting a mammography-related service alongside a tomosynthesis service and whether laterality should be reflected on the claim.
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Answer
Summarizes the coding discussion using mammography and breast tomosynthesis references, Medicare fee schedule context, bilateral indicator concepts, and modifier considerations.
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Look out
Notes a brief forward-looking mention of related coverage in an upcoming publication issue.
What You Will Learn
- How the article frames a laterality question involving mammography and breast tomosynthesis services
- Why Medicare fee schedule bilateral indicator status is part of the discussion
- How the article characterizes the relationship between unilateral and bilateral reporting concepts
- What general type of modifier guidance is discussed for this imaging topic
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Outpatient facility coding professionals
Codes Discussed
Modifiers Discussed
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