Medicare does not allow modifier 50 with this procedure and as you know, many carriers follow Medicare's edit's. I have, however, heard of other coders appending RT/LT (Commercial carriers) to this service if the documentation supported the intensity of the procedure. Be ready to appeal though. I wish I could tell you that I've personally submitted it this way. I've only had experience with this procedure when peformed unilaterally. Another route could be adding modifier 22 if the providers entire documentation reflects the requirements for this modifier.
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