Wiki ASC MOdifier billing for Washington State

[suriayani]

Hi,
I am wondering wht the ruling is on attaching modifier 50 (bilateral) or RT and LT for surgical suite?

I was told that ASC charges for bilateral procedure should not go out with mod 50 and that if the procedure is doen for both sides only one CPT code should be use because it will not be paid anyway for the second code (LT) when we submit to the payer. IS that right?

Thanks
SuriayaniRaip
Rockwood Clinic
Spokane, WA

 

[elenax]

I believe it depends on the insurance guidelines and the procedure you are coding, because I have billed with 50 or LT/RT modifiers in an ASC and I get paid...please let me know if a misunderstood your question

 

[mbort]

I dont know the specific rules for Washington, but I do code for many ASC's throughout the states. My experience is that it is best to seperate them out on separate line items using the RT/LT and the 59 modifier on the second line item. Of course the payment on the 2nd line item all depends upon your insurance contracts.

64483-rt
64483-59-lt

Hope this helps
Mary

 

[suriayani]

Thanks ladies I appreciate the replies. I'll have to re-post this question out to my clinic. Thanks.
Suriayani