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Thread: Bilateral Xray Profee - MITS billing, OH Caid

  1. #1

    Question Bilateral Xray Profee - MITS billing, OH Caid

    AAPC: Back to School
    Here is an example: patient has "radiologic examination, knee; 1 or 2 views" on both knees, we bill 73560-26 - the catch is that it's Ohio Medicaid, now using MITS online; Although they now accept RT & LT modifiers, they won't accept this on radiology codes, they also will not accept 50 modifier; if you bill 2 separate units, one denies as a duplicate, then I "attach" the medical record in MITS & send it and it still denies; I've tried billing 2 units on one line; I've tried to verify correct billing in every publication I can find, but I cannot find this exact issue

  2. #2


    I have seen this before with a different payer - have you tried 73560-26 and 73560-26-76? Maine Medicaid also requires the use of 51 on some procedures indicating that it is multiple procedures -- this was the first that I had ever experienced this and I have worked for quite a few state medicaid programs!

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