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Modifiers -59 vs -50

  1. #11
    Iowa City, IA
    Exam Training Packages
    we have tried billing on 2 lines and 1 with a 59 mod
    we have also tried billing on 2 lines and 1 w/ a -51,LT mod & the other w/ just the RT
    Is this CPT 21390 considered a bilateral already?

  2. #12
    Duluth, Minnesota
    well, after a bit more research on the actual procedure itself - it does appear (at least to me) that there isn't a RT/LT or "bilateral" to this procedure - it is simply - the orbital floor (periorbital).
    If I were you, I'd ask the surgeon exactly what it was, just to be sure that it isn't a RT/LT/50 procedure.

    The description of the 21390 does not say bilateral (I'm thinking because there isn't a bilateral periorbital floor)
    Donna, CPC, CPC-H

  3. #13
    Pittsburgh Central
    I've always billed with a 59:


    Some insurers will deny but pay after I send a written appeal with the OP note.

    I recently attended a Medicare webinar on modifiers (I'm in PA) & they suggested using the 76 modifier:


    I haven't tried this yet so I don't have any experience with payment in this situation.

  4. #14
    Duluth, Minnesota
    linda, when you find the answer - could you let me know what it is! ! I'd sure appreciate it.
    Donna, CPC, CPC-H

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