Wiki Medicare ASC Bilateral Procedures

[rfields]

We are a pain management organization with several ASC's. We have been billing our bilateral procedures with the 50 modifier for Medicare patients for both the Facility and the Professional claim. As of October first Medicare has been denying our Facility claims stating there is a CPT/Modifier mismatch. Is anyone aware of new guidelines regarding ASC bilateral procedures? Our system automatically rejects us billing Medicare claims with RT/LT on two separate lines.

 

[clbarfels]

modifier 50

Modifier 50 isn't to be used for ASC billing. You need to use multiple lines with the appropriate modifier.