tci Outpatient Facility Coding Alert - 2018 Issue 7

Reader Question: Refrain from Modifier Use on Bilateral Indicator 2 Codes

Question: Should I use code G0279 to bill out a unilateral tomosynthesis with a 77065? If so, should I apply a LT/RT modifier to it to tell the payer that it’s a unilateral service? Idaho Subscriber Answer: Since 77065 (Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral) is inherently a unilateral procedure, you might think that a respective unilateral tomosynthesis code may exist to compliment 77065. However, there is actually only one tomosynthesis code, G0279 (Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066), which is applicable for both unilateral and...

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