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rt/lt questions-help!!

  1. Exclamation rt/lt questions-help!!
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    Some of the docs put an rt/lt modifier on cast application and some do not. ex: 29345(application long leg cast) Does it need rt/lt on it?

    Also, breast lesion excision- do i use rt and lt? I know that if it is a lesion it is considered skin- no rt and lt. Are breast lesions an exception to the rule?

    Injection Procedures- like 20610(aspiration/injection into major joint or bursa) or 20550 (injection into single tendon sheath or ligament)..Do those need an rt/lt modifier?

    Any answers will be greatly appreciated!! Thanks

  2. #2
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    Cast application would not require rt/lt but it may not hurt to use one.

    Breast lesions - if you are only doing one breast rt/lt would not be required, but then again it may not hurt.

    20610 - if one side rt/lt would not be required but may not hurt to use. 20550 same, but if more than one you need -59 first.

    Hope that helps.
    Lisa Bledsoe, CPC, CPMA

  3. Default
    Thanks for your answer! But with rt & lt- Don't you either definitely need them or not?
    Last edited by kmezyk; 09-14-2010 at 09:41 AM.

  4. #4
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    surgical procedures like 20610 and 20550 are modified with 50 if bilateral. bill one unit with the 50 modifier to indicate right and left then insurance pays 150% of the allowed for the code.

  5. #5
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    Quote Originally Posted by wenkeck View Post
    surgical procedures like 20610 and 20550 are modified with 50 if bilateral. bill one unit with the 50 modifier to indicate right and left then insurance pays 150% of the allowed for the code.
    20550 cannot be billed with -50 as it is not specific to laterality...you can have two 20550 on the same side/same limb, etc.

    Check with your insurance plans to know which method of bilateral coding they prefer. Many want 2 line items (20610, 20610-50 at 50%).
    Lisa Bledsoe, CPC, CPMA

  6. #6
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    Quote Originally Posted by kdaesch View Post
    Thanks for your answer! But with rt & lt- Don't you either definitely need them or not?
    Not if you are treating one side rather than bilateral.
    Lisa Bledsoe, CPC, CPMA

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