AAPC - Back to school
Results 1 to 5 of 5

Thread: Medicare Bilateral Procedures..HELP????

  1. #1
    Join Date
    Apr 2007

    Question Medicare Bilateral Procedures..HELP????

    AAPC: Back to School
    I am with an ASC and we are having some confusion with our billing for bilateral procedures. We do a good bit of pain mgmt injections and we use to bill the same CPT with a RT mod on the first and then a LT on the second CPT.

    Ex. 64483 -RT
    64483 -LT

    The we are told that now Medicare wants them billed on the same line using the one CPT code and change the units with no modifiers.

    Ex. 64483 (2 Units) No mods

    We started billing like the above example and then got a ton of denials from Medicare saying the claim lacks information needed for adjudification, missing/incomplete/invalid days or units of service, and missing/incomplete/invalid "to" date of service.

    We called Medicare and the rep was absolutely no help at all. So I tried billing then again the old way with the RT and LT modifiers and those are being denied too stating the related or qualifying claim/service was not identified on this claim.

    HELP!!! I'm not sure what we should do. I have several claims like this that we have not received any payment on. Hopefully one of you guys can help me out or have dealt with this yourself.

    Thanks so much!!!

    Olivia Justus, CPC-H

  2. #2
    Join Date
    Apr 2007


    This code has a bilateral indicator of 1 so by my understanding it has to be filed with modifier 50 on one line with 1 unit.

  3. #3
    Join Date
    Apr 2007


    Thanks Wendy. I will give that a shot. I know in the past they did not like the -50 modifier but they change their policies so much it's hard to keep up with it.


  4. #4
    Join Date
    Apr 2007


    Okay, about a month ago we were told to do the bilateral injections with a RT and a LT, without the 50 modifier. Now they deny it? I can just not keep up with this! Why do they complicate this so much?

  5. #5
    Join Date
    Apr 2007
    Athens, Ga.


    View this CMS link for the answer to your question...


Similar Threads

  1. Bilateral Procedures
    By beatriz88b in forum Medical Coding General Discussion
    Replies: 6
    Last Post: 08-06-2015, 01:39 PM
  2. Medicare & bilateral procedures
    By hsheetz68 in forum ENT/Otolaryngology
    Replies: 3
    Last Post: 06-05-2013, 06:31 PM
  3. Medicare Bilateral Procedures
    By nyyankees in forum Orthopaedics
    Replies: 2
    Last Post: 12-08-2009, 08:23 AM
  4. What is Up with Bilateral Procedures and Medicare???
    By broncsrox in forum Orthopaedics
    Replies: 3
    Last Post: 10-23-2009, 01:07 PM
  5. Bilateral procedures - I am having a problem
    By miller_ide in forum Medical Coding General Discussion
    Replies: 7
    Last Post: 04-09-2009, 08:21 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.