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HELP! bilateral retrograde

  1. Default HELP! bilateral retrograde
    Medical Coding Books
    my doc is billing cpt 52332 he also has 74420 as bilateral . How do i bill/code 74420 as bilateral when a 50 modifier is not accepted . LT and RT modifiers are not accepted as well.

  2. #2
    Smile Bilateral Retrograde
    You have a few things going on here-you mentioned that your doc did a bilateral retrograde and you are billing 52332 and 74420-first, I'm assuming you just left out that your doctor also inserted an indwelling stent otherwise 52332 isn't correct. If he just did cysto, bilateral retrograde then 52005 is your code and most payers (including Medicare) won't allow -50 modifier since their logic is the bladder is not a bilateral organ (I know, but we have two UO's!). You can bill 74420 IF the retrograde was done by your practice (i.e. Your equipment) OR you can bill 74420-26 if your physician is the doctor who is the intrep MD and dictates the full report for the x-ray. The radiology code (74420) would not allow for bilateral modifier. So to clarify, if you just did cysto, bilateral retrograde pyelogram in the facility and your physician is the intrep MD and dictates a report for the RPG, your codes are: 52005, 74420-26.
    Hope this helps!
    Ann Linton, CPC, CEMC, CUC

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