Wiki Bilateral mastectomies 50 vs RT/LT modifiers

[tjkellogg]

I'm needing to know if it is better to bill 19303-50 on one line vs 19303 RT & 19303-59-LT on separte lines? These pt's have breast implants and diagnosis of breast cancer in one breast but decide to have bilateral mastectomies. We are using 174.9 on one breast and V07.8 on the other breast. Thanks

 

[FTessaBartels]

Payer specific

This tends to be payer specific. Some payers want the -50 modifier - billed on one line with quantity 1 but double the fee. Some want it on one line with with quantity 2 and double fee. Some payers want to see it billed on two lines, with the -50 modifier appended to the second line, each coded with 1 unit and individual fee. And some like two lines with -RT and -LT modifiers.

Personally, I like this last option best, as I think it is the most clear. But I'm not the payer.... S I G H

Hope that helps.

F Tessa Bartels, CPC, CEMC