icon mod 50 in CPT


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This is my interpretation and need clarification on the 50 icon in cpt.
If the 50 icon is next to the CPT code then it means that this procedure is a "bilateral procedure" and you report it once for both sides with no modifier.
If this 50 icon is not present next to the CPT code then it is considered a "Unilateral" procedure unless the word Unilateral is in the description.
Example: CPT 92225, there is no 50 icon therefore if done on both eyes you would report it with a 50 modifier. The Opthalmology Coding Companion clearly states that this is a unilateral procedure.
Please if someone can clarify this for me I would greatly appreciate it. I think I'm going crazy.

thank you,
Susan Gormsen, CPC


True Blue
Hibbing, Minnesota
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Susan - I don't know what 50icons you're talking about in the CPT book - I don't have any "icons" - I use the CPT 2008 Professional Edition - when the code description says "bilateral" or "bilateral or unilateral" in it - you do not use modifier .50 - what CPT book do you use?

that being said - Bilateral surgery rules do not apply to code 92225 - do not use modifier 50 on 92225. (I guess that leaves you with using LT or RT or units x2)

(per the RVU schedule status indicator #3 in the bilateral surgery column rules)

{that's my opinion on the posted matter}