Normally Add Modifier 50 On Bilateral Ct Shots

By Author: erinarticle
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Some modifier 50 rules could lead to a lot of confusion


What should you do when the orthopedist injects both of a patient's wrists to treat carpal tunnel syndrome? Just file 20526 with modifier 50 appended and just forget about it? Is it so?


Well, not so fast. If the physician injects both the patient's wrists to treat CTS, you will usually add modifier 50 (bilateral procedure) to 20526 (Injection, therapeutic [for instance. local anesthetic, corticosteroid], carpal tunnel), says an orthopedics professional coder at Fletcher Allen Health Care in Burlington, Vt. But then there are exceptions though.


This code has a ‘1' bilateral status indicator, meaning that this injection can be reported bilaterally. For many payers, this would mean reporting the bilateral injections by appending modifier 50 to the 20526 CPT code and billing one unit of service.


But then it is always best to authenticate the insurance plan's preference for reporting bilateral services as there some variances to ‘modifier 50 and one unit of service coding. ...
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For instance, Oregon Medicaid does not accept modifier 50, as was relayed by an office manager at an orthopedic practice in Klamath Falls, Ore.


If the carrier does not want you to file 20526-50, it'll typically accept 20526-LT (Left side [used to identify procedures on the left side of the body) and 20526-RT (Right side [used to identify procedures on the right side of the body]) instead.

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