Wiki Bilateral Procedure Question

[angieboore]

I have a quick question..... I have been billing my bilateral procedure codes (I'm in a ASC, so many different codes) as one line item with a LT and RT modifier - with the understanding that the insurance should pay at 150%.

I'm now being told by another employee (who is not a coder) that this is wrong and I have to bill 2 line items for all bilateral procedures and calculate for double payment.

Can anyone shed some light on this for me?

Thanks

Angie

 

[mitchellde]

When you use LT and RT modifiers you always use 2 lines one with RT and one with LT. You cannot use more than one anatomic modifier per line item. If you use a 50 modifier you bill on one line. The payer will auto discount the second line.

 

[angieboore]

Thanks Debra.

I was given different information by others (relatively new to current job) and now being told to do things another way with conflicting information and without being able to discuss the whys and reasoning.

I knew I could count on AAPC members

I appreciate it.

Angie