code 70030 has a Bilateral Indicator â3â on the Medicare Physician Fee Schedule Database (MPFSDB). This means, when performed bilaterally, the full fee schedule amount is payable for âeachâ side. The 50 percent reduction that occurs with Bilateral Indicator â1â procedure codes is not applicable to Bilateral Indicator â3â procedure codes.
In order to receive the full fee schedule amount for Bilateral Indicator â3â procedure codes performed bilaterally, the days/units (quantity billed) field must reflect â2â even when submitting CPT Modifier 50 or when submitting HCPCS Modifiers RT and LT on the same detail line.
Note: These instructions apply only to Bilateral Indicator â3â procedure codes. When billing Bilateral Indicator â1â services with CPT Modifier 50, the days/units must be submitted as â1â.
The MPFSDB indicators for procedure codes can be viewed by accessing the following website: http://www.cms.hhs.gov/PFSlookup/ (then go to the Physician Fee Schedule Search).
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