Wiki 20610 bilateral - help with modifiers and units

houmaob1714

Contributor
Messages
20
Best answers
0
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?
 
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.
 
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?
 
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
 
Last edited:
Hi there, Medicare wants 50 but private payers will vary so you'll need to check the plan's medical policy.
 
Top