Wiki How to bill code correctly?

[ksamples]

I am billing 30117 and the physician did both sides of the nose. How do I bill this correctly because I have seen conflicting information everywhere. You cannot append a 50 modifier to the 30117 so.......

Do I bill 30117 - XS modifier on one line?

Do I bill 30117 on one line with 2 units?

Do I bill 30117 on two separate lines with XS modifier or without any modifiers?

Please Help? Thank You!

 

[nsteinhauser]

I would bill it once. I thought when it has the "0" code under the bilateral heading in the Nat'l Physician Fee Schedule that it can only be billed once per surgical session, even if you are addressing a "right" and "left" side. Anyone else have information on this situation?

 

[thomas7331]

The CMS NCCI site's medically unlikely edits tables allow up to two units of this procedure per date of service. I believe the restriction on the use of the bilateral modifier is due to the fact that the procedure is for a specific lesion - not for a specific anatomical location that has bilateral counterparts. I would recommend billing the two procedures on separate lines with the 59 or XS modifier on the second procedure to show that it was distinct from the first.

 

[nsteinhauser]

Do you happen to have the website address handy for the MUE tables?
Thank you for your help.