How well do I remember grappling with this issue! I appealed successfully with Anthem with one of these bilateral claims, and was planning on following thru with the other denied bilateral claims (yes, they only paid one side). We tried unit billing (one per side), then LT and RT (which didn't work) and finally remained firm on the modifier 50 status. Sent MCR payment indicator and policy on bilateral injections and also pulled up Anthem's ONLY policy which supported the bilateral payment, got their higher levels involved and even they weren't sure. Ultimately (and its listed as the reason when you utilize the claims editor function), they follow a CPT Assistant article which doesn't doesn't support bilateral billing. Unless McKesson has changed their edits (which I doubt), the rejection is hard-wired into the process. Unfortunately, it's a long road, and you need to make a decision to fight each and every claim for full payment, or accept the position of just being paid less than what other insurance companies might allow. Before 2011 we didn't seem to be having the problem of being paid for bilateral, but apparently some changes were made in the edits which seriously affected reimbursement.