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Wiki Medicare bilateral reimbursement

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KMCFADYEN

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Is anyone having problems with Medicare bilateral reimbursement. Specifically, we are billing large joint injections (20610) with a 50 modifier to Palmetto GBA JII. They are supposed to reimburse at 150% but are only reimbursing for a single injection.
 
Brenda

I had the same problem with a dry eye test I was billing for. The would not allow the 50 modifier. I have to bill it on two line items with the RT and LT modifier with 1 unit. Hope this helps.
 
You could get an example of a previous claim by the same carrier and have them over the phone compare it to the claim in question. They might have a system error.
 
I've never been able to get payment for 20610-50 from any carrier here in Florida. I've always had to break them apart unto the two sides.
 
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