Modifier 50 vs LT/RT

mmunoz21

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Hi,

Mod 50 is bilateral procedures, then we have modifier LT and RT..what's the difference when do we use one instead of the other?

THanks
 

jharrell

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I have always been told that it depends on what the carrier prefers. I use LT RT with I have bilateral x-rays. I would like to know what others do as well?

Jessica Harrell, CPC
 

cconroycpch

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Medicare guidelines will tell you to bill with modifier 50 for bilateral procedures. However, I found that the normally pay incorrectly with the 50 modifier. I always use the LT and RT modifiers for all insurance companies.
 

Lisa Bledsoe

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I use -50 on bilateral procedures and -LT/-RT for bilateral xrays. Have not experienced any (major) reimbursement problems.
 
Last edited:

codegirl0422

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For my carriers

it depends on the payer:

Medicare usually wants Modifier 50 and billed on 1 line, the quantity is one but you double the price. If you bill it on separate lines and do not double the price they usually pay wrong. Their manual states you can do either way, modifier 50 on one line or RT/LT. But also, watch out, they do have some LCD's/LMRP's that direct you to a certain way. The LCD for facet injections and other injections instructs you to use modifer 50 billed on one line. (for medicare look in chapter 12 of the claims processing manual.)

Alabama's Medicaid requires you to use RT and LT. They do recognize modifier 50 for reimbursement reasons. It is just an informational modifier.

United Health Care still wants Modifier 50 per their website: "Modifier 50identifies the same procedures that are performed as a bilateral service. The procedure should be billed on one line with modifier 50 and one unit with the full charge for both procedures. A procedure code submitted with modifier 50 is a reimbursable service as set forth in this policy only when it is listed on the UnitedHealthcare Bilateral Eligible List. "

BC of Alabama: their provider manual says you can use either modifier 50 or RT/LT. I usually use modifier 50: the procedure code billed on two lines with modifier 50 on the second line. Reimbursement has been correct so far.

Aetna accepts either way. This was published in one of their monthly newsletters.

Hope this helps. But like everyone else has stated, it is important to check with your individual carriers for your area.

codegirl :)
 

MLMiksch

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RT / LT or -50

I took the CPC on 05.17.08, there were several questions using RT/LT or modifier -50. How do you know when to use either of these, which is correct?
I know you use these when there are two, (legs, arms, breast, ears, eyes,...) but which is the correct one to use?

Thanks,
Lynn
 

mbort

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I also use RT/LT will all carriers including Medicare. Medicare has some codes (pain) that they specifically want the RT/LT on so to keep the confusion down, I am consistent across the board by using the RT/LT. If a carrier has a problem with it I review on a case by case basis.
 

MLMiksch

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Modifier -50 or RT/LT

I know it depends on the insurance as to which modifier to use for reimbursement.

But........On the CPC it does not list the name of any insurance, therefore, which do you use RT/LT or -50.
This is on the 2008 CPC Exam. I don't remember the question, but the multipile choices were RT/LT AND -50. I guessed at it, because I wasn't sure. Did anyone else have this on the CPC?


Thanks,
Lynn
 

jberg

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RT/LT or 50 modifier

HI,

If using RT and LT both instead of a 50 modifier...Do you need to do so on one line or two?
 

mitchellde

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Rt and LT are anatomic modifiers and you are allowed only one anatomic modifier per line item so use two lines when reporting RT and LT. Technically RT and LT are for facility outpatient and ASC use however many payers do accept them for physician claims due to the clarity they provide. Therefore I would tend to think on the CPC exam the correct answer would be the 50 modifier.
 
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