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Bilateral X-ray Modifiers

  1. #1
    Default Bilateral X-ray Modifiers
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    I work in Rheumatology and we are having an issue with United Healthcare paying for bilateral x-rays of any sort. I bill out with the LT/RT modifier per Medicare guidelines and United is denying them asking for 1 line with 50 modifier. Is anyone else having this issue? How did you rectify this? Thanks for your input

  2. Red face Bilateral modifier-50 for UHC
    Please use this below link for UHC policy related to bilateral modifier-50.

    https://www.supercoder.com/webroot/u...Procedures.pdf

    Reimbursement Guidelines:-
    If a procedure can be billed bilaterally, the provider should bill the service with a modifier 50. If the
    procedure is identified by the terminology as bilateral or unilateral, the 50 modifier should not be reported.


    Thanks,
    Kokila Venkatesan CPC-A

  3. #3
    Default
    Quote Originally Posted by KokilaVenkatesan View Post
    Please use this below link for UHC policy related to bilateral modifier-50.

    https://www.supercoder.com/webroot/u...Procedures.pdf

    Reimbursement Guidelines:-
    If a procedure can be billed bilaterally, the provider should bill the service with a modifier 50. If the
    procedure is identified by the terminology as bilateral or unilateral, the 50 modifier should not be reported.


    Thanks,
    Kokila Venkatesan CPC-A
    Kokila only issue with that is the link you sent is dated 2014 and they just started not paying correctly 7/2018. Also Medicare guidelines state that the codes are category C which means both modifiers 50 and LT/RT can be billed.

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