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bilateral procedures

  1. #1
    Default bilateral procedures
    Medical Coding Books
    Doctor documented the following:

    DIAGNOSTIC BLOCKADE OF THE MEDIAL BRANCH OF THE
    PRIMARY DORSAL RAMUS INNERVATING THE
    BILATERAL CERVICAL FACETS AT C3-4, C4-5, C5-6, C6-7

    Charge was put in as:

    64470-50 (1)qty
    64472-LT (4)qty
    64472-RT (4)qty


    Is this correct....looks funny to me.

    How do insurance companies want bilateral procedures...I am so confused!

  2. Default
    A lot depends on the insurance. I know Blue Shield of Michigan requires a 50 modifier on the first level and then qty for any additional. For Medicare we have started putting 50 modifiers on each level.

    In this case I would do:
    64470-50
    64472-50
    64472-50
    64472-50

    And if it's Medicare, depending on the state, they may want a 76 modifier on each additional level.

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