20610 bilateral - help with modifiers and units

houmaob1714

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What is the correct way to bill Medicare, Blue Cross Blue Shield, United Healthcare, Humana, etc. for 20610 bilateral? Would it be 20610-50 with 1 or 2 units or separetly with RT and LT modifiers?
 

JWEILER

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20610 bilateral

I believe that Medicare, BCBS and Humana require bilateral procedures billed on one line using the -50 modifier and one unit. Be sure to double your fee, though. United generally likes them on separate lines. Hope that helps.
 

houmaob1714

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Yes thank you very much. It is my understanding that Medicare will pay 150% of the allowed amount billing with modifier 50, 1 unit. Is that correct?
 

houmaob1714

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If an injection is given for both knees and both shoulders, would I bill the following way:

20610 1 unit, 50 modifier, double the fee (knees)
20610 1 unit, 50-51 modifier, double the fee (shoulders)

Or does it need to be all on one line: 20610 2 units, 50-51 modifier, knees & shoulders, double the fee
 
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