Wiki rt/lt questions-help!!

[kmezyk]

Some of the docs put an rt/lt modifier on cast application and some do not. ex: 29345(application long leg cast) Does it need rt/lt on it?

Also, breast lesion excision- do i use rt and lt? I know that if it is a lesion it is considered skin- no rt and lt. Are breast lesions an exception to the rule?

Injection Procedures- like 20610(aspiration/injection into major joint or bursa) or 20550 (injection into single tendon sheath or ligament)..Do those need an rt/lt modifier?

Any answers will be greatly appreciated!! Thanks

 

[Lisa Bledsoe]

Cast application would not require rt/lt but it may not hurt to use one.

Breast lesions - if you are only doing one breast rt/lt would not be required, but then again it may not hurt.

20610 - if one side rt/lt would not be required but may not hurt to use. 20550 same, but if more than one you need -59 first.

Hope that helps.

 

[kmezyk]

Thanks for your answer! But with rt & lt- Don't you either definitely need them or not?

 

[wenkeck]

surgical procedures like 20610 and 20550 are modified with 50 if bilateral. bill one unit with the 50 modifier to indicate right and left then insurance pays 150% of the allowed for the code.

 

[Lisa Bledsoe]

surgical procedures like 20610 and 20550 are modified with 50 if bilateral. bill one unit with the 50 modifier to indicate right and left then insurance pays 150% of the allowed for the code.

20550 cannot be billed with -50 as it is not specific to laterality...you can have two 20550 on the same side/same limb, etc.

Check with your insurance plans to know which method of bilateral coding they prefer. Many want 2 line items (20610, 20610-50 at 50%).

 

[Lisa Bledsoe]

Thanks for your answer! But with rt & lt- Don't you either definitely need them or not?

Not if you are treating one side rather than bilateral.