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Wiki 70030
- Thread starter RADCODER
- Start date
dmaec
True Blue
code 70030 has a Bilateral Indicator “3” on the Medicare Physician Fee Schedule Database (MPFSDB). This means, when performed bilaterally, the full fee schedule amount is payable for “each” side. The 50 percent reduction that occurs with Bilateral Indicator “1” procedure codes is not applicable to Bilateral Indicator “3” procedure codes.
In order to receive the full fee schedule amount for Bilateral Indicator “3” procedure codes performed bilaterally, the days/units (quantity billed) field must reflect “2” even when submitting CPT Modifier 50 or when submitting HCPCS Modifiers RT and LT on the same detail line.
Note: These instructions apply only to Bilateral Indicator “3” procedure codes. When billing Bilateral Indicator “1” services with CPT Modifier 50, the days/units must be submitted as “1”.
The MPFSDB indicators for procedure codes can be viewed by accessing the following website: http://www.cms.hhs.gov/PFSlookup/ (then go to the Physician Fee Schedule Search).
In order to receive the full fee schedule amount for Bilateral Indicator “3” procedure codes performed bilaterally, the days/units (quantity billed) field must reflect “2” even when submitting CPT Modifier 50 or when submitting HCPCS Modifiers RT and LT on the same detail line.
Note: These instructions apply only to Bilateral Indicator “3” procedure codes. When billing Bilateral Indicator “1” services with CPT Modifier 50, the days/units must be submitted as “1”.
The MPFSDB indicators for procedure codes can be viewed by accessing the following website: http://www.cms.hhs.gov/PFSlookup/ (then go to the Physician Fee Schedule Search).
please clarify
I am a new coder so i just need clarification. My billing program ALife indicates because we xrayed both orbits for foreign bodies we need to code 70030 x 2. I'm not sure by your description whether I should add the 2nd code to our radiology report or not, one for each eye. I believe we should one LT and one RT.
I am a new coder so i just need clarification. My billing program ALife indicates because we xrayed both orbits for foreign bodies we need to code 70030 x 2. I'm not sure by your description whether I should add the 2nd code to our radiology report or not, one for each eye. I believe we should one LT and one RT.