Wiki Bilateral X-ray Modifiers

[melissasilva1031@gmail.com]

I work in Rheumatology and we are having an issue with United Healthcare paying for bilateral x-rays of any sort. I bill out with the LT/RT modifier per Medicare guidelines and United is denying them asking for 1 line with 50 modifier. Is anyone else having this issue? How did you rectify this? Thanks for your input

 

[KokilaVenkatesan]

Bilateral modifier-50 for UHC

Please use this below link for UHC policy related to bilateral modifier-50.

https://www.supercoder.com/webroot/upload/general_pages_docs/document/BilateralProcedures.pdf

Reimbursement Guidelines:-
If a procedure can be billed bilaterally, the provider should bill the service with a modifier 50. If the
procedure is identified by the terminology as bilateral or unilateral, the 50 modifier should not be reported.


Thanks,
Kokila Venkatesan CPC-A

 

[melissasilva1031@gmail.com]

Please use this below link for UHC policy related to bilateral modifier-50.

https://www.supercoder.com/webroot/upload/general_pages_docs/document/BilateralProcedures.pdf

Reimbursement Guidelines:-
If a procedure can be billed bilaterally, the provider should bill the service with a modifier 50. If the
procedure is identified by the terminology as bilateral or unilateral, the 50 modifier should not be reported.


Thanks,
Kokila Venkatesan CPC-A

Kokila only issue with that is the link you sent is dated 2014 and they just started not paying correctly 7/2018. Also Medicare guidelines state that the codes are category C which means both modifiers 50 and LT/RT can be billed.