Wiki Medicare denial for bilateral x-rays

[tlm5506]

Hello.
We were told that you cannot use LT and RT modifiers with x-rays when submitting claims to Medicare. We are now receiving rejections from Medicare for bilateral x-rays being taken. They will pay one x-ray but deny the other x-ray as a duplicate. Any suggestions on what modifier to use to get these both paid?
Thanks.

 

[edean]

Before we can attempt to help with your question, can you please provide the state in which you are billing these Medicare claims. We need to find out who your Medicare contractor is first.

Then, provide the CPT codes along with the diagnoses you billed with them for these X-rays.

After we get this information, we can attempt to help with your question.

Thanks,

 

[debipbarik]

You may not bill with LT or RT modifier for unilateral as per you state, But for Bilateral you should simply use modifier 50. it's common sense that two same CPT on same date o service without modifier will get denial.

 

[TCicio]

Hello.
We were told that you cannot use LT and RT modifiers with x-rays when submitting claims to Medicare. We are now receiving rejections from Medicare for bilateral x-rays being taken. They will pay one x-ray but deny the other x-ray as a duplicate. Any suggestions on what modifier to use to get these both paid?
Thanks.

In Texas we bill as follow's (see example below)

73130 RT x 1 unit
73130 59, LT x 1 unit

Have NEVER had a denial, hope this helps

 

[ValerieBatesHoffCPCCPMA]

Bilateral X-ray Noridian (Southern CA)

That is also how we bill our bilateral x-rays (minus the 59 modifier).