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2020 guidelines for bilateral add on codes

areynaga

New
Messages
7
Best answers
0
Is anyone else getting denials for billing add on codes with 2 line items per CPT guidelines? Our MAC just told us to bill 64494 with modifier 50, even though CPT guidelines now state that it should not be billed with modifier 50. Other insurances are telling us the same, or that their records haven't been updated yet.
 

bdcoyne8

Networker
Local Chapter Officer
Messages
35
Location
Idaho Falls, ID
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Our billing office is not allowing us to bill it with modifier 50 as per Medicare's instruction. The scrubber removes it from the claim. Does anyone else have this problem? What are you doing for it?
 

areynaga

New
Messages
7
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0
Our billing office is not allowing us to bill it with modifier 50 as per Medicare's instruction. The scrubber removes it from the claim. Does anyone else have this problem? What are you doing for it?
Our office has a call into our local MAC trying to get someone higher up the chain to give us some clarification, but it seems by the post above that Medicare may not follow CPT guidelines on this issue--this is going to be a mess!
 

eurovw

New
Messages
9
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0
Called Noridian Medicare, called UHC West, both still want modifier 50. did corrections and reopenings, paid when billed with modifier 50. Go figure.
 
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