Wiki 20926 -50?

[generic808]

So the person before me in my position billed 20926 -50 (tissue graft) along with 19350 (nipple/areola recon bilateral). We got denied saying that "per physician fee schedule database, the 150% payment adjustment for bilateral procedures may not apply to procedure 20926 because of physiology/anatomy or because the code description specifically states that it is a unilateral procedure and there is an existing code for the bilateral procedure". There is no bilateral code for tissue graft so I'm thinking I should bill this 2 units? Any suggestions or opinions on this matter would be greatly appreciated. Thanks in advance.

 

[JEYCPC]

20926-Modifiers
May Use: 51
Don't Use: 50 62 66 80 81 82
Situational: Other: 59 XE XS XP XU Anatomic: LT RT Global: 58 78 79

I would use LT/RT.

 

[generic808]

20926-Modifiers
May Use: 51
Don't Use: 50 62 66 80 81 82
Situational: Other: 59 XE XS XP XU Anatomic: LT RT Global: 58 78 79

I would use LT/RT.

Thanks for the response, JEYCPC. I actually did submit it with an LT RT about 10 minutes after I posted the question. Now I'll wait and see. Thanks again.