cpt code 19125

Hibbs

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I was wondering what the correct coding would be for bilateral procedure, RT & LT cpt code 19125, I believe that it should be 19125/modifier 50. Would this be correct?:)
 

mitchellde

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I was wondering what the correct coding would be for bilateral procedure, RT & LT cpt code 19125, I believe that it should be 19125/modifier 50. Would this be correct?:)
No, this code is for a single lesion , not a single lesion on each breast. If you have multiple lesions regardless of left or right you will use the add on code for the second one and so on.
 
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L Bateman, CPC

You certainly can use modifier 50 on 19125 to bill for bilateral breast biopsies. I have done this for years and have never had a problem. I only use the add on code for lesions biopsied in the same breast. The Medicare fee schedule states, "150% payment adjustment for bilateral procedures applies" to this code. You can itemize it separately if you want to, but it's so much easier using the modifier 50 and the reimbursement is the same.
 
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