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Wiki Medicare modifier -50 & -59 payments

Runner88

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Williamsport, MD
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For an ASC: Where can I find the new Medicare policy on the billing of bilateral procedures and multiple same procedures? We have been billing per occurence for each ex.:

1) 69436
2) 69436-50

1) 64483
2) 64484
3) 64484-59

Medicare has not been paying 2nd/3rd line. I called local Medicare carrier and was told to bill Bilateral on 1 line with the modifier only 1 unit. I did this as well and the payment is still not right. I am on the verge of pulling my hair out! Thanks!
 
modifier 59

When billing transforaminal steroid injection multiple levels you should use the RT/LT modifier. Remember when using an add-on code such as 64484 you do not use modifier 59 as it cannot be used without the parent code 64483. example:

64483 RT
64484 RT
or
64483 RT
64484 LT
64484 LT

bilateral bill it like this:

64483 RT
64483 LT

I'm not sure how many levels of injections Medicare will pay for besides 2.
 
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