Wiki 20610 bilateral hip injection/mod 50

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Trendale

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Hello,
Can someone tell me the appropriate way to bill a bilateral hip injection. Can you use modifier 50 with 20610? Can someone verify the status indicator? I am hearing that it is a 1, which states mod 50 does not apply, but I just referenced that it was a 2, which states it does apply????:confused:

Thanks!:)
 
letisha said:
Hello,
Can someone tell me the appropriate way to bill a bilateral hip injection. Can you use modifier 50 with 20610? Can someone verify the status indicator? I am hearing that it is a 1, which states mod 50 does not apply, but I just referenced that it was a 2, which states it does apply????:confused:

Thanks!:)
Click to expand...

Status indicator 1 means you can bill as a bilateral code.
And when I code 20610 bilaterally I use RT, LT but it all depends on how the payer wants it billed. Some ins companies may want 20610, 20610-50 or just 20610-50, or 20610-RT, 20610-LT. Where I am RT, LT works for me. :)

go to pg 13, that tells what the status indicators mean for bilateral (50)
http://www.cms.hhs.gov/Transmittals/Downloads/R1358CP.pdf
 
Bilateral Indicator:

0=Do not submit procedure with mod 50
1=modifier 50 applies
2=Do not submit procedure with mod 50
3=modifier 50 applies
9=Concept does not apply-Do not submit modifier 50

20610 has a indicator of 1-Modifier 50 could apply if bilateral. This can be located by selecting the "payment status indicator" and entering your CPT code.

http://www.cms.hhs.gov/pfslookup/02_PFSsearch.asp

As for the modifier...some carriers prefer 50, one line, one unit. Some carriers prefer LT/RT modifiers. There are many discussions from previous threads... Best advise...contact your carrier for their policy on bilateral procedures.
 
I am having a little bit of a hard time using that particular website. Does anyone know of another website that might also be helpful to me for status indicator information? I am fairly new to all of this and could definitely use some more hands on information.
 
What are you not understanding on the website I gave you? I can try to explain it.
Starts on pg 13 and tells what each indicator means, if it shows a 0 in the bilateral column of the payment policy for mcare then that code is not a bilateral code, if shows a 1 then that is a bilateral code, 2 not bilateral and so on. Number 1 is the only indicator that shows it can be billed out bilaterally.
Bilateral Surgery Indicator (Modifier 50)

0 = 150 percent payment adjustment for bilateral procedures does not apply.

1 = 150 percent payment adjustment for bilateral procedures applies.

2 = 150 percent payment adjustment for bilateral procedure does not apply.

3 = The usual payment adjustment for bilateral procedures does not apply.

Please let me know if that clearifies it better. ;)
 
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