|
#1
|
|||
|
|||
|
I know this is a very basic question but I can't get a straight answer... is there one way that is accepted by Medicare, Medicare replacements, and commertial insurances to bill bilateral procedures? Every site I look at says something different.
some examples are: 92135 -50, 2 units, single charge $ or 92135 -50, 1 unit, double charge $ or 92135-LT, single charge 92135-RT, single charge Are any of these ways universal??? HELP! |
|
#2
|
|||
|
|||
|
It just depends on your carrier. Here in Alabama, Medicare wants xxxxx-50 with one unit and double price; Alabama Medicaid wants xxxxx-LT X 1 and xxxxx-RT X 1; most commercial carriers prefer xxxxx X 1 and xxxxx-50 X 1. And since they are paying they get to call the shots.
Have fun. Jerri, CPC |
|
#3
|
|||
|
|||
|
According to Medicare, the application of the bilateral payment rule is dependent on the bilateral indicator on the Medciare Fee Schedule Database MFSDB).The bilateral payment adjustment does not apply to a procedure with 0,2 or 3 indicator and CPT 92135 falls under indicator 3. Do not use modifier -50, instead use RT, LT- on one line with (2) in unit column.
Hope this helps. Nidhi M., CPC www.symbiosisbilling.com |
|
#4
|
|||
|
|||
|
Thank you sooo much! But where do you find that information? (MFSDB)? Thanks again!
|
|
#5
|
||||
|
||||
|
http://www.cms.hhs.gov/pfslookup/02_PFSsearch.asp
Click on payment policy indicators and enter your information. This link provides the status indicator. The link below translates the definitions of those indicators. http://www.cms.hhs.gov/PhysicianFeeS...umPerPage=2000 Under downloads, click RVU09C Open the PDF and go to pages 10-11 for bilateral.
__________________
Rebecca CPC, CPMA, CEMC Your click COUNTS... http://www.thebreastcancersite.com/c...faces?siteId=2 CLICK to give FREE mammograms! |
|
#6
|
|||
|
|||
|
Perfect! Thanks!! This helps tremendously!
|
|
#7
|
|||
|
|||
|
This information is very helpful for all to review on a periodic basis for a refresher. We get so used to going through the motions, that it is good to reveiw and refresh. Thank you.
|
|
#8
|
|||
|
|||
|
I have found this document helpful:
http://www.lamedicare.com/provider/d...MODFLW2000.pdf |
![]() |
| Thread Tools | |
|
|