JBowyer
Contributor
We have a dispute regarding whether to use modifier 59 or modifier 51 with LT and RT. We have two urology procedures performed in same operative session that are bundled, but a modifier is allowed. 50590 on the left and 52356 on the right. We have three opinions. #1 50590-LT; 52356-59, RT #2 50590-LT; 52356-51,RT #3 50590; 52356-59
One brought the example below:
Example 6: Column 1 Code / Column 2 Code - 29827/29820
>CPT Code 29827 – Arthroscopy, shoulder, surgical; with rotator cuff repair
>CPT Code 29820 – Arthroscopy, shoulder, surgical; synovectomy, partial
CPT code 29820 should not be reported and modifier 59 should not be used if both
procedures are performed on the same shoulder during the same operative session because
the shoulder joint is a single anatomic structure. If the procedures are performed on
different shoulders, modifiers RT and LT should be used, not modifier 59.
LT and RT have not effect on the actual processing of the claim for payment, because they are informational. Correct?
Can you help us?
Thanks,
Urology Group
One brought the example below:
Example 6: Column 1 Code / Column 2 Code - 29827/29820
>CPT Code 29827 – Arthroscopy, shoulder, surgical; with rotator cuff repair
>CPT Code 29820 – Arthroscopy, shoulder, surgical; synovectomy, partial
CPT code 29820 should not be reported and modifier 59 should not be used if both
procedures are performed on the same shoulder during the same operative session because
the shoulder joint is a single anatomic structure. If the procedures are performed on
different shoulders, modifiers RT and LT should be used, not modifier 59.
LT and RT have not effect on the actual processing of the claim for payment, because they are informational. Correct?
Can you help us?
Thanks,
Urology Group