Radiology Coding Alert

Question: I noticed in the October issue that you said to report modifier -50 using two procedure codes and appending the modifier to the second one. Aren't bilateral procedures supposed to be reported with a single procedure code, with the modifier appended?

Ohio Subscriber Answer: This is an excellent point. Methods of reporting bilateral procedures vary, and the Reader Question you're referring to ("Prevent Denial With These Modifiers") was all about checking with your payer to learn its preference. You've provided a perfect example of why this is so important.

October's RCA indicated that some payers prefer you to report bilateral procedures by appending modifier -50 (Bilateral procedure) to the second report of the applicable procedure code.

As you suggest, there are numerous other payers that  prefer you to report one procedure code with modifier -50 appended. The major one to know about is Medicare. But don't be too quick to assume that all Medicare carriers and intermediaries want you to report it this way. Some of them break from Medicare's rules and choose their own method of reporting.

Lesson learned: Always, always, always obtain your individual payer's preference in writing and follow it if you want to get reimbursed.