Which breast reconstruction codes are you referring to that are inherently bilateral? The parenthetical directive immediately under the title Repair and/or Reconstruction (pg 80 of 2011 CPT Professional Edition) states To report bilateral procedure, report modifier 50 with the procedure code (emphasis added by FTB)
Therefore, if the procedure is performed on only one breast you simply report the code. If it is performed bilaterally, you append mod 50 (or RT, LT, depending on carrier preference).
Hope that helps,
F Tessa Bartels, CPC, CEMC
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join