Interventional Radiology - code bilateral

jmcpolin

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I would code 36500, 36500-59 75893 75893-59 due to different locations and I don't think that the 50 or RT LT modifiers are allowed.
 

donnajrichmond

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Payor preference.

HTH :)
Danny's right - there is no consistency among payers concerning modifiers - even different Medicare contractors.
For instance, I almost never use 76 because I "grew up" as a coder in Louisiana where the Louisiana Medicare contractor has this definition - "76 -A repeated procedure by the same physician on the same patient, same date, same exact body site. ALL of the listed criteria MUST be met before ‘76' is appropriate."
By that definition, I couldn't use -76 in this situation for Medicare.
But other payers would insist on it.
Same with modifier 50 for bilateral. For years AMA said that -50 should not be used on radiology 70000 codes but many Medicare payers had policies that listed codes that must use -50 if bilaterals were done and they included 70000 codes.
 

Lynda Wetter

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Danny's right - there is no consistency among payers concerning modifiers - even different Medicare contractors.
For instance, I almost never use 76 because I "grew up" as a coder in Louisiana where the Louisiana Medicare contractor has this definition - "76 -A repeated procedure by the same physician on the same patient, same date, same exact body site. ALL of the listed criteria MUST be met before ‘76' is appropriate."
By that definition, I couldn't use -76 in this situation for Medicare.
But other payers would insist on it.
Same with modifier 50 for bilateral. For years AMA said that -50 should not be used on radiology 70000 codes but many Medicare payers had policies that listed codes that must use -50 if bilaterals were done and they included 70000 codes.
Thanks thats what i thought about it being payer policy, just havent heard of using 76.
 
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