Wiki Emodifiers

[TMB1965]

Can anyone tell me where I can find guidelines on when to use the emodifers, lt, rt or 50? These confuse the heck out of me! Also for example if my provider does a 66761 on the rt and the lt do you need a modifier 51 on the second one? Any suggestions would really help! Thank you!

 

[mitchellde]

LT is used when a unilateral procedure is performed only on the Left side, and Rt is used when performed on the right side. 50 is used when you perform a unilateral procedure on both sides. Some carriers prefer that you not use the 50 modifier for a bilateral procedure and instead list the procedure twice using the lt and rt modifiers. You would not need the 51 unless required by payer. When in doubt check with the payer on how they prefer to have bilateral procedures submitted.

 

[AlaskanCoder]

Modifiers E1, E2, E3 and E4 are used when the code is specific for an eyelid. While the eyes are bilateral (we have 2 in mirror image), we have 4 eyelids, so they are not considered bilateral. In the case of procedures such as 67800-67808 - Excision of chalazion or 67810 Inscisional biopsy of eyelid skin, the use of -LT, -RT or -50 would be inappropriate as you don't have a right or left eyelid, but you have a left upper eyelid and a left lower eyelid, so the E1-E4 modifiers would be appropriate to describe which eyelid(s) was treated. If 67810 is performed on more than one lid, the second and subsequent lids would be subject to a multiple procedure reduction.

Hope that helps,
Karen Hill, CPC, CPB, CPMA
AHIMA Approved ICD-10-CM Trainer