LT and RT are to be used for procedures performed on the left side only or the right side only of defined bilateral body parts or organs. 50 is to be used when a unilateral procedure is performed on both sides of a defined bilateral body part or organ. If a procedure contains the word bilateral (or both sides) as a part of the descriptor then you do not use a modifier, and you cannot use its unilateral code with the 50 modifier. Just remember that skin has no laterality so for skin procedures you cannot use LT, RT, or 50 modifiers.
Now having said all of this some carriers like BCBS would prefer that you double line code the bilateral procedures using LT on one line and RT on the other.
If I have not confused you terribly I hope you found this helpful.
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