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Medicare Bilateral Procedures..HELP????

  1. #1
    Question Medicare Bilateral Procedures..HELP????
    Medical Coding Books
    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
    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
    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
    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
    View this CMS link for the answer to your question...

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