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64530 Bilateral?

  1. #1
    Default 64530 Bilateral?
    Exam Training Packages
    Can anyone tell me if the celiac plexus procedure can be billed w/ modifier 50?


  2. #2
    this code has a bilateral surgery indicator "0". Submit the surgery with a quantity of “1.” Do not submit these procedures with CPT modifier 50.
    Payment Basis:
    The lower of the actual submitted charge for both procedures or 100% of the fee schedule amount for a single procedure. Payment is not increased for these procedures because physiology or anatomy are not appropriate (e.g., surgeries on the large intestine), or because the code descriptor specifies that it is a unilateral procedure and there is an existing code for a bilateral procedure.

  3. #3
    Thank you for the quick response!!! I thought 0 was correct but couldn't find the documentation.

    many thanks!!

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