Modifier .50 is a statistical modifier that affects pricing. the LT/RT mods are statistical informational modifiers. There is a ranking for "how to" attach modifiers, pricing modifiers FIRST - statistical modifers that affect pricing SECOND. The statistical information modifiers fall SECOND also, only if there are not other modifiers that affect payment.
This info can be found in the March 2008 CMS Modifier Reference
Other info I use from "medicare" -
Hints for using the modifier 50 - USE to report a procedure done BILATERALLY in same session - DO NO use if code indicates muliple occurences - DO NOT use if code indicates the procedure applies to different body parts - DO NOT use if code description included "bilateral" or "unilateral"
Hints for using the modifiers LT/RT - use to identify procedures performed on the right/left side of a paired organ or central lateral anatomic site body. - USE when the procedure is performed on only one side to identify the side operated on. - DO NOT use if code indicates the procedure applies to different body sites or anatomic structures. - DO NO use RT/LT if a more specific modifier is available - DO NOT use RT and LT when modifier 50 is appropriate.
(again, Medicare website)
in this case "if" it was done bilaterally - given it's "1" rating on the RVU schedule - I would indeed use the .50 and not RT/LT - (if it was done bilaterally)
That being said:
Mary, I understand how/why you'd do it that way by what you've posted. I'm just saying, I do it differently. My response to the question is based on my years of coding exerience and audits galore also. I too, am confident in my opinion, it's why I gave it. What I state is what works for me, my facility.
Really - no need for "puffing out the chest" ..
This is a forum for discussion, we don't all have to agree - I've learned much from others and often post for opinions on things I'm doing. I get wonderful responses as to why something different might work or be a better way. When I have issues I research other coders ways of doing things, if it makes sense and it's correct coding - I have no problem changing the ways we do it. If the way we do things "now" doesn't seem to have any issues, change wouldn't be needed. I'm simply stating my opinion (note my disclaimer at the end of each post) it's "my opinion", it's NOT gospel. It what works for me, my facility and it too is based on years of experience.
you and I obviously disagree on this issue - I've no problem with that ..
jessieindiego can take the information we all provide and make her own decision.(in fact, it would be very wise of her to do her own research, she has a great starting point with the opinions posted here!)
{again, that's still my opinion on the posted matter}