Wiki podiatry - I am once again confused

[denali]

I am once again confused - my provider did a bilateral toe nail removal - I billed with Rt and Lt - since she didn't provide exact toes - but the modifiers were there - Medicare added a 51 to the second removal. Is that correct? This is a unilateral procedure, so why are they adding a modifier to decrease my value?
Thanks once again for the assistance.
Cyndi

 

[racheleporterwilliams]

podiatry

give the procedure code a -50 (-50 means both sides, lt and rt), since the MD didn't provide which toes....hope this helps

I am once again confused - my provider did a bilateral toe nail removal - I billed with Rt and Lt - since she didn't provide exact toes - but the modifiers were there - Medicare added a 51 to the second removal. Is that correct? This is a unilateral procedure, so why are they adding a modifier to decrease my value?
Thanks once again for the assistance.
Cyndi

 

[codegirl0422]

Medicare normally wants modifier 50 on one line with the billed amount doubled enless there is a LCD or NCD stating different. I looked up the codes: 11730-11732 & 11750-11752 on the RBRVS and bilateral policy does not apply, when bilateral doesn't apply then mutiple procedure policy applies so MC processed correctly.

Hope this helps

 

[mbort]

since these were actual toes, I would have applied the appropriate T modifiers, put them on separate lines and added 59 on the second one. (just as you would for hammertoes)