14021 w/ mod 50?

[mebjones83]

Does anyone know if 14021 can be billed with modifier 50? A provider at my practice performed scalp surgery on the LT and then the RT (same session). Can 14021-50 be coded? If not, can 14021-RT and 14021-59-LT be billed? Thanks!

 

[xXxPARAGONxXx]

Per CMS Physician Fee Schedule, cannot use laterality modifiers (LT, RT, 50) for 14021. The same applies to most integumentary procedure codes, as the skin is considered a single organ without laterality.

If indeed two distinct sites were involved, code 14021 twice, with modifier -59 on the second.

 

[gracerobin2004]

Similar question with L73.2 & 11450 There is a note to add 50 if bilateral. Do I need RT if done on Rt. Axilla? Thanks

 

[xXxPARAGONxXx]

Similar question with L73.2 & 11450 There is a note to add 50 if bilateral. Do I need RT if done on Rt. Axilla? Thanks

11450 has Bilt Surg indicator of 1 which means laterality modifiers are applicable. Therefore, you should use them.

 

[gracerobin2004]

Where will I reference Bilt surgical indicator information?

 

[xXxPARAGONxXx]

Where will I reference Bilt surgical indicator information?

Medicare Physician Fee Schedule (PFS) Search Tool

For 11450:
https://www.cms.gov/medicare/physician-fee-schedule/search?Y=0&T=4&HT=0&CT=0&H1=11450&M=5

https://www.cms.gov/medicare/physician-fee-schedule/search
https://www.cms.gov/files/document/physician-fee-schedule-guide.pdf

https://med.noridianmedicare.com/web/jeb/specialties/surgery/bilateral-surgery