20160831 - FREE Code Books with Exam Prep Packages | Learn More

AAPC - August DL Sale: 50% OFF
Page 1 of 2 12 LastLast
Results 1 to 10 of 12

Thread: Modifier 50 vs LT/RT

  1. #1

    Default Modifier 50 vs LT/RT

    Hi,

    Mod 50 is bilateral procedures, then we have modifier LT and RT..what's the difference when do we use one instead of the other?

    THanks

  2. #2

    Default

    I have always been told that it depends on what the carrier prefers. I use LT RT with I have bilateral x-rays. I would like to know what others do as well?

    Jessica Harrell, CPC

  3. #3
    Join Date
    Apr 2007
    Location
    Palm Beach
    Posts
    69

    Default

    Medicare guidelines will tell you to bill with modifier 50 for bilateral procedures. However, I found that the normally pay incorrectly with the 50 modifier. I always use the LT and RT modifiers for all insurance companies.

  4. #4
    Join Date
    Apr 2007
    Location
    Greeley, Colorado
    Posts
    2,046

    Default

    I use -50 on bilateral procedures and -LT/-RT for bilateral xrays. Have not experienced any (major) reimbursement problems.
    Last edited by Lisa Bledsoe; 05-09-2008 at 11:51 AM.

  5. #5

    Default Modifier 50 vs LT/RT

    Mod 50 is for bilateral surgery codes and LT/RT are for radiology codes

  6. #6
    Join Date
    Apr 2007
    Location
    Milwaukee WI
    Posts
    4,452

    Default Depends on the payor

    Some payors don't accept the [50] modifier, but want RT / LT instead.
    F Tessa Bartels CPC

  7. #7

    Lightbulb For my carriers

    it depends on the payer:

    Medicare usually wants Modifier 50 and billed on 1 line, the quantity is one but you double the price. If you bill it on separate lines and do not double the price they usually pay wrong. Their manual states you can do either way, modifier 50 on one line or RT/LT. But also, watch out, they do have some LCD's/LMRP's that direct you to a certain way. The LCD for facet injections and other injections instructs you to use modifer 50 billed on one line. (for medicare look in chapter 12 of the claims processing manual.)

    Alabama's Medicaid requires you to use RT and LT. They do recognize modifier 50 for reimbursement reasons. It is just an informational modifier.

    United Health Care still wants Modifier 50 per their website: "Modifier 50identifies the same procedures that are performed as a bilateral service. The procedure should be billed on one line with modifier 50 and one unit with the full charge for both procedures. A procedure code submitted with modifier 50 is a reimbursable service as set forth in this policy only when it is listed on the UnitedHealthcare Bilateral Eligible List. "

    BC of Alabama: their provider manual says you can use either modifier 50 or RT/LT. I usually use modifier 50: the procedure code billed on two lines with modifier 50 on the second line. Reimbursement has been correct so far.

    Aetna accepts either way. This was published in one of their monthly newsletters.

    Hope this helps. But like everyone else has stated, it is important to check with your individual carriers for your area.

    codegirl

  8. #8

    Default RT / LT or -50

    I took the CPC on 05.17.08, there were several questions using RT/LT or modifier -50. How do you know when to use either of these, which is correct?
    I know you use these when there are two, (legs, arms, breast, ears, eyes,...) but which is the correct one to use?

    Thanks,
    Lynn

  9. #9
    Join Date
    Apr 2007
    Location
    ENGLEWOOD/DENVER
    Posts
    2,338

    Default

    I also use RT/LT will all carriers including Medicare. Medicare has some codes (pain) that they specifically want the RT/LT on so to keep the confusion down, I am consistent across the board by using the RT/LT. If a carrier has a problem with it I review on a case by case basis.

  10. #10

    Default Modifier -50 or RT/LT

    I know it depends on the insurance as to which modifier to use for reimbursement.

    But........On the CPC it does not list the name of any insurance, therefore, which do you use RT/LT or -50.
    This is on the 2008 CPC Exam. I don't remember the question, but the multipile choices were RT/LT AND -50. I guessed at it, because I wasn't sure. Did anyone else have this on the CPC?


    Thanks,
    Lynn

Page 1 of 2 12 LastLast

Similar Threads

  1. Replies: 2
    Last Post: 09-18-2015, 01:17 PM
  2. Modifier 59 vs Modifier 91 for Laboratory
    By leahrey in forum Modifiers
    Replies: 1
    Last Post: 06-23-2015, 12:01 PM
  3. MODIFIER PT VS MODIFIER 33 Screening Colonoscopy
    By Ann Johnson in forum Modifiers
    Replies: 2
    Last Post: 07-19-2012, 07:08 AM
  4. Modifier 58 versus Modifier 78
    By Ramona03 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-04-2012, 12:10 PM
  5. Modifier 51 Versus Modifier 59
    By Sborkowski in forum Modifiers
    Replies: 3
    Last Post: 05-26-2009, 03:59 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.