Wiki Modifier 50, X-rays, and Medicare

[dballard2004]

A basic coding question here....can anyone point to specific guidance from Medicare regarding modifier 50 and bilateral x-rays? Does Medicare accept modifier 50 for bilateral x-rays or do we need to report modifiers LT and RT instead? Where in the Medicare regs can I find this info, please? Thanks

 

[RebeccaWoodward*]

As indicated in §20.6.2, modifier -50, while it may be used with diagnostic and radiology procedures as well as with surgical procedures, should be used to report bilateral procedures that are performed at the same operative session as a single line item. Modifiers RT and LT are not used when modifier -50 applies. A bilateral procedure is reported on one line using modifier -50. Modifier -50 applies to any bilateral procedure performed on both sides at the same session.

Modifier -50 (bilateral) applies to diagnostic, radiological, and surgical procedures

http://www.cms.gov/Transmittals/downloads/R442CP.pdf

Also...
Services in this category are generally radiology procedures or other diagnostic tests which are not subject to the special payment rules for other bilateral procedures. (Pages 220-221)

http://www.cms.gov/manuals/downloads/clm104c23.pdf

 

[dballard2004]

Very helpful. Thanks so much!