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podiatry - I am once again confused

  1. #1
    Cool podiatry - I am once again confused
    Medical Coding Books
    I am once again confused - my provider did a bilateral toe nail removal - I billed with Rt and Lt - since she didn't provide exact toes - but the modifiers were there - Medicare added a 51 to the second removal. Is that correct? This is a unilateral procedure, so why are they adding a modifier to decrease my value?
    Thanks once again for the assistance.
    Cyndi

  2. #2
    Default podiatry
    give the procedure code a -50 (-50 means both sides, lt and rt), since the MD didn't provide which toes....hope this helps

    Quote Originally Posted by denali View Post
    I am once again confused - my provider did a bilateral toe nail removal - I billed with Rt and Lt - since she didn't provide exact toes - but the modifiers were there - Medicare added a 51 to the second removal. Is that correct? This is a unilateral procedure, so why are they adding a modifier to decrease my value?
    Thanks once again for the assistance.
    Cyndi
    Rachele Porter, AS, CPC, CPC-H, CEDC
    no weapons formed against me shall prosper

  3. Default
    Medicare normally wants modifier 50 on one line with the billed amount doubled enless there is a LCD or NCD stating different. I looked up the codes: 11730-11732 & 11750-11752 on the RBRVS and bilateral policy does not apply, when bilateral doesn't apply then mutiple procedure policy applies so MC processed correctly.

    Hope this helps

  4. #4
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    Default
    since these were actual toes, I would have applied the appropriate T modifiers, put them on separate lines and added 59 on the second one. (just as you would for hammertoes)

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