Results 1 to 3 of 3

Modifier 50, X-rays, and Medicare

  1. #1
    Location
    Overland Park, KS
    Posts
    1,166
    Default Modifier 50, X-rays, and Medicare
    Medical Coding Books
    A basic coding question here....can anyone point to specific guidance from Medicare regarding modifier 50 and bilateral x-rays? Does Medicare accept modifier 50 for bilateral x-rays or do we need to report modifiers LT and RT instead? Where in the Medicare regs can I find this info, please? Thanks
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    As indicated in §20.6.2, modifier -50, while it may be used with diagnostic and radiology procedures as well as with surgical procedures, should be used to report bilateral procedures that are performed at the same operative session as a single line item. Modifiers RT and LT are not used when modifier -50 applies. A bilateral procedure is reported on one line using modifier -50. Modifier -50 applies to any bilateral procedure performed on both sides at the same session.

    Modifier -50 (bilateral) applies to diagnostic, radiological, and surgical procedures

    http://www.cms.gov/Transmittals/downloads/R442CP.pdf

    Also...
    Services in this category are generally radiology procedures or other diagnostic tests which are not subject to the special payment rules for other bilateral procedures. (Pages 220-221)

    http://www.cms.gov/manuals/downloads/clm104c23.pdf
    Last edited by RebeccaWoodward*; 09-23-2010 at 06:53 AM.

  3. #3
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    Very helpful. Thanks so much!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

Similar Threads

  1. Billing X-Rays to Medicare
    By stephcova33 in forum Billing/Reimbursement
    Replies: 1
    Last Post: 06-17-2015, 04:39 AM
  2. What Modifier to use on X-rays
    By melerickid in forum Modifiers
    Replies: 3
    Last Post: 05-25-2015, 07:36 PM
  3. X-rays for Medicare patients
    By Lori22 in forum Chiropractic
    Replies: 0
    Last Post: 03-04-2013, 03:06 PM
  4. x-rays with modifier 52
    By dimar923 in forum Modifiers
    Replies: 0
    Last Post: 08-20-2012, 10:08 AM
  5. Appropriate modifier use with E/M and X-rays
    By HCCCoder in forum Modifiers
    Replies: 7
    Last Post: 12-22-2008, 07:23 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.