Wiki CPT help - Dr has performed FNA with imaging

[natraj21]

Dr has performed FNA with imaging guidance bilateral thyroid lobe nodules. Do we need to add modifier 50 to both 10022 and 76942. Please let me know.

 

[srinivas r sajja]

10022- has a bilateral indicator. 0- Bilateral surgery payment rules do not apply, do NOT use modifier 50.
.Some codes with an indicator of “0” may be performed more than once on a given day. However, even if performed on opposite sides of the body, these services would never be considered bilateral.

 

[natraj21]

Thank you Srinivas for the reply. where did u get this information? I think its not stated in CPT. How can I know that what are all the codes with '0' indicator.

 

[srinivas r sajja]

http://www.cms.gov/pfslookup/02_PFSs...es&next=Accept

Select "payment policy indicators" next...

Select all modifiers on your drop down key

enter your CPT code-8th column over

https://www.aapc.com/memberarea/forums/showthread.php?t=36005

Bilateral Indicators
0- Bilateral surgery payment rules do not apply, do NOT use modifier 50.
1- Bilateral surgery payment rules apply (150%), Use modifier 50 if bilateral. Units = 1
2- Bilateral surgery payment rules do not apply. Already priced as bilateral. Do not use modifier 50. Units = 1
3- Bilateral surgery payment rules do not apply. Do not use modifier 50. Units = 1 or 2.
9- Bilateral concept does not apply.

Although bilateral indicators “0” and “3” can be billed with the LT and RT modifiers, there are some differences between the two indicators

 

[natraj21]

Thank you Srinivas. It is so much helpful.

Thanks

Natarajan Chellamuthu