{"id":2413,"date":"2024-12-30T12:46:35","date_gmt":"2024-12-30T12:46:35","guid":{"rendered":"https:\/\/medibillmd.com\/blog\/?p=2413"},"modified":"2025-03-07T10:00:24","modified_gmt":"2025-03-07T10:00:24","slug":"modifier-50","status":"publish","type":"post","link":"https:\/\/medibillmd.com\/blog\/modifier-50\/","title":{"rendered":"Modifier 50 Description, Examples, and Usage Guidelines"},"content":{"rendered":"\n<p>Left side, right side. One side, two sides. One claim line, separate claim line. Gosh! If your medical coding and billing woes for bilateral surgical procedures are never-ending, then it is time to quit stressing and start grasping. That\u2019s right! We are here to tell you all about the bilateral modifier 50. Report 1 unit of this modifier with the appropriate procedural code to get up to 150% of the standard fee in a single sitting.&nbsp;<\/p>\n\n\n\n<p>So, let\u2019s uncover the details of modifier 50\u2019s description, real-world applications, and accurate usage guidelines. Your journey to the right billing starts here!&nbsp;&nbsp;<\/p>\n\n\n\t\t\t\t<div class=\"wp-block-uagb-table-of-contents uagb-toc__align-left uagb-toc__columns-1 uagb-toc__collapse uagb-block-659ea1cd      \"\n\t\t\t\t\tdata-scroll= \"1\"\n\t\t\t\t\tdata-offset= \"30\"\n\t\t\t\t\tstyle=\"\"\n\t\t\t\t>\n\t\t\t\t<div class=\"uagb-toc__wrap\">\n\t\t\t\t\t\t<div class=\"uagb-toc__title\">\n\t\t\t\t\t\t\tTable Of Contents\t\t\t\t\t\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 384 512\"><path d=\"M192 384c-8.188 0-16.38-3.125-22.62-9.375l-160-160c-12.5-12.5-12.5-32.75 0-45.25s32.75-12.5 45.25 0L192 306.8l137.4-137.4c12.5-12.5 32.75-12.5 45.25 0s12.5 32.75 0 45.25l-160 160C208.4 380.9 200.2 384 192 384z\"><\/path><\/svg>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"uagb-toc__list-wrap \">\n\t\t\t\t\t\t<ol class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#modifier-50-description\" class=\"uagb-toc-link__trigger\">Modifier 50 &#8211; Description<\/a><li class=\"uagb-toc__list\"><a href=\"#modifier-50-examples\" class=\"uagb-toc-link__trigger\">Modifier 50 &#8211; Examples<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#bilateral-probing-of-lacrimal-canaliculi\" class=\"uagb-toc-link__trigger\">Bilateral Probing of Lacrimal Canaliculi<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#bilateral-administration-of-a-nerve-blocker\" class=\"uagb-toc-link__trigger\">Bilateral Administration of a Nerve Blocker\u00a0<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#bilateral-removal-of-ovaries-andor-fallopian-tubes\" class=\"uagb-toc-link__trigger\">Bilateral Removal of Ovaries and\/or Fallopian Tubes<\/a><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#accurate-usage-guidelines-for-modifier-50\" class=\"uagb-toc-link__trigger\">Accurate Usage Guidelines for Modifier 50\u00a0<\/a><ul class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#refer-to-medicares-physician-fee-schedule-database\" class=\"uagb-toc-link__trigger\">Refer to Medicare\u2019s Physician Fee Schedule Database<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#provide-documentation-for-bilateral-procedure\" class=\"uagb-toc-link__trigger\">Provide Documentation for Bilateral Procedure\u00a0<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#do-not-use-modifier-50-under-these-conditions\" class=\"uagb-toc-link__trigger\">Do Not Use Modifier 50 Under These Conditions<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#understand-that-commercial-payers-may-have-their-own-rules\" class=\"uagb-toc-link__trigger\">Understand That Commercial Payers May Have Their Own Rules\u00a0<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#increase-the-billed-amount-to-150-of-the-fees-on-the-claim\" class=\"uagb-toc-link__trigger\">Increase the Billed Amount to 150% of the Fees on the Claim\u00a0<\/a><li class=\"uagb-toc__list\"><li class=\"uagb-toc__list\"><a href=\"#append-modifier-50-on-a-single-claim-line\" class=\"uagb-toc-link__trigger\">Append Modifier 50 on a Single Claim Line\u00a0<\/a><\/li><\/ul><\/li><\/ul><\/li><li class=\"uagb-toc__list\"><a href=\"#summary\" class=\"uagb-toc-link__trigger\">Summary<\/a><\/ul><\/ul><\/ol>\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Modifier 50<\/strong><strong> &#8211; Description<\/strong><\/h2>\n\n\n\n<p>Modifier 50 is typically used with surgical Current Procedural Terminology (CPT) codes to indicate that the procedure was performed on body\u2019s both sides during the same operative session. Hence, it is a bilateral modifier that can help the surgeon collect reimbursement at 150% of the standard fee (100% for the initial procedure and 50% for replicating the procedure on the other side of the body). So, in other words, modifier 50 is also a payment modifier with a significant impact on the net payment.&nbsp;<\/p>\n\n\n\n<p>The Centers for Medicare and Medicaid Services (CMS) allows using this modifier for increased payment when bilateral procedures are performed. However, you must follow their <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Physician Fee Schedule Database<\/a> (MPFSDB) to determine if this modifier should be appended with the chosen procedural code. We will discuss more of this later.&nbsp;&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Modifier 50<\/strong><strong> &#8211; Examples<\/strong><\/h2>\n\n\n\n<p>Knowing when to append modifier 50 makes all the difference when it comes to upping your coding game. Do it right, and you can collect 150% of the cost in one sitting without requesting additional resources. Do it wrong, and you might lose the reimbursement for even the unilateral procedures, as the unnecessary inclusion of modifier 50 will trigger a claim denial. To help you, we have stated a few scenarios below where this modifier is applicable.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Bilateral Probing of Lacrimal Canaliculi<\/strong><\/h3>\n\n\n\n<p>Blocked tear ducts, a common and harmless condition in infants, can become dangerous for adults, leading to watery eyes and infection. Middle-aged women are more likely to develop blocked tear ducts, also known as dacryostenosis, because of aging and hormonal changes. To remove the obstruction from the drainage system, healthcare providers probe the lacrimal canaliculi. It opens the pathway that connects the eyes and nasal cavity for seamless drainage of tears.&nbsp;&nbsp;<\/p>\n\n\n\n<p>If a provider unblocks the tear ducts through lacrimal canaliculi probing in both eyes, modifier 50 will be appended with CPT code 68840 to explain the bilateral procedure and collect 150% of the stated charge, which is typically between $140 and $170.&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Bilateral Administration of a Nerve Blocker&nbsp;<\/strong><\/h3>\n\n\n\n<p>Morton\u2019s neuroma is the non-cancerous yet painful growth of nerve tissues in the foot (typically between the third and fourth toes), causing difficulty in walking and running and persistent pain in the ball of the foot. Bilateral Morton\u2019s neuroma, or the growth of nerve tissues in both feet, is rare. Only around <a href=\"https:\/\/www.mortonsneuroma.com\/blog\/bilateral-mortons-neuroma-occur\/\" rel=\"nofollow noopener\" target=\"_blank\">10-15%<\/a> of patients are diagnosed with it. However, it needs immediate medical attention to relieve the patient of sharp pain and discomfort.&nbsp;<\/p>\n\n\n\n<p>Providers inject an anesthetic agent or nerve blocker (corticosteroid) into the area around the digital nerves on the foot\u2019s sole to reduce inflammation and treat Morton\u2019s neuroma. If the procedure is performed bilaterally (on both feet), the modifier 50 will be appended with CPT code 64455.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Bilateral Removal of Ovaries and\/or Fallopian Tubes<\/strong><\/h3>\n\n\n\n<p>This example is an interesting one and goes slightly against the conventional rules of using modifier 50. So, generally speaking, Medicare does not recognize this modifier for procedures performed on midline organs like the uterus, bladder, and esophagus. Moreover, when the CPT code\u2019s descriptor states \u201cone or both\u201d or \u201cunilaterally or bilaterally\u201d, it is assumed to include payment for the procedure on the other side and not in need of this modifier.&nbsp;<\/p>\n\n\n\n<p>However, with the laparoscopic procedure coded 58661, the situation is a little different. Medicare has assigned this code a bilateral surgical indicator \u20181\u2019. Hence, if the left and right ovaries\/fallopian tubes or a combination of both were removed during the same operative session, modifier 50 will be appended with CPT code 58661. Please note that OB\/GYNs often advise removing ovaries and fallopian tubes to prevent cancer or treat conditions like ectopic pregnancy.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Accurate Usage Guidelines for <\/strong><strong>Modifier 50&nbsp;<\/strong><\/h2>\n\n\n\n<p>So, now that you know which situations mandate the use of modifier 50, let\u2019s consider some of its billing best practices to know for sure when the modifier is applicable and will be accepted by government and private insurance payers. The following guidelines will help you avoid denials related to this modifier.&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Refer to Medicare\u2019s Physician Fee Schedule Database<\/strong><\/h3>\n\n\n\n<p>Medicare has developed a unique billing and coding system for surgical procedures. In its physician fee schedule database (MPFSDB), Medicare lists \u2018Bilateral Surgery Indicators\u2019 alongside each CPT code to help the providers ascertain if modifier 50 can be appended or not.&nbsp;<\/p>\n\n\n\n<p>You can refer to the table below to see if the bilateral surgery indicator quoted in front of the chosen CPT code will guarantee a payment a 150% payment adjustment or not.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-table is-style-stripes\"><table><thead><tr><th class=\"has-text-align-center\" data-align=\"center\"><strong>Indicator&nbsp;<\/strong><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>Explanation<\/strong><\/th><th class=\"has-text-align-center\" data-align=\"center\"><strong>Use Modifier 50<\/strong><\/th><\/tr><\/thead><tbody><tr><td class=\"has-text-align-center\" data-align=\"center\">0<\/td><td class=\"has-text-align-center\" data-align=\"center\">Payment adjustment for bilateral procedures does not apply.<\/td><td class=\"has-text-align-center\" data-align=\"center\">NO&nbsp;<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\">1<\/td><td class=\"has-text-align-center\" data-align=\"center\">Payment adjustment for bilateral procedures applies.&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">YES<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\">2<\/td><td class=\"has-text-align-center\" data-align=\"center\">Payment adjustment for bilateral procedures does not apply. Already priced as bilateral.<\/td><td class=\"has-text-align-center\" data-align=\"center\">NO<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\">3<\/td><td class=\"has-text-align-center\" data-align=\"center\">Payment adjustment for bilateral procedures does not apply. Bill 1 unit for each side&nbsp;<\/td><td class=\"has-text-align-center\" data-align=\"center\">YES<\/td><\/tr><tr><td class=\"has-text-align-center\" data-align=\"center\">9<\/td><td class=\"has-text-align-center\" data-align=\"center\">The concept of bilateral procedures does not apply.<\/td><td class=\"has-text-align-center\" data-align=\"center\">NO<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>Therefore, you can only append this modifier when the bilateral surgery indicator assigned to that CPT code is <strong>1 or 3<\/strong>. Refer to the <a href=\"https:\/\/www.cms.gov\/status-indicators\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">CMS\u2019s Status Indicators <\/a>for more guidance.&nbsp;<\/p>\n\n\n\n<p>While using modifier 50 when the bilateral surgical indicator is 1 is clear-cut, let us explain how this modifier is applicable when the indicator is 3. Generally, radiology procedures or other diagnostic tests will have a bilateral surgery indicator 3. So, Medicare will expect you to report the procedures for each side separately. You will bill 1 unit for the right side with modifier 50 and 1 unit for the left side with the same modifier to indicate that bilateral testing was performed on the same day. Medicare will reimburse you at 100% of the fee schedule for each side.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Provide Documentation for Bilateral Procedure&nbsp;<\/strong><\/h3>\n\n\n\n<p>You will have to maintain and submit complete documentation to prove the medical necessity of the procedure performed on both sides during the same operative session. Moreover, the surgical notes must clearly explain how the procedure was performed bilaterally for accurate and timely reimbursement.&nbsp;<\/p>\n\n\n\n<p>For example, in the case of Morton\u2019s neuroma (nerve tissue growth) on both feet, you can submit X-ray reports to suggest the need for bilateral anesthetic injections (nerve blockers).&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Do Not Use <\/strong><strong>Modifier 50<\/strong><strong> Under These Conditions<\/strong><\/h3>\n\n\n\n<p>Using modifier 50 will be considered inappropriate when:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The code descriptor clearly states that the procedure is \u201cbilateral\u201d. Therefore, the physician fee schedule for the said CPT code includes payment for both sides.&nbsp;<\/li>\n\n\n\n<li>The code descriptor clearly states that the procedure is \u201cunilateral\u201d. For example, \u201cTotal thyroid lobectomy, unilateral; with or without isthmusectomy\u201d.&nbsp;<\/li>\n\n\n\n<li>The procedure was performed on two different areas of the body\u2019s same side. For example, left arm and leg.&nbsp;<\/li>\n\n\n\n<li>The procedure was performed on midline organs like the nasal septum, spine, or bladder. Because these procedures are inherently bilateral.&nbsp;<\/li>\n\n\n\n<li>The procedure was performed on areas or sites that are not bilateral. For example, thyroid.&nbsp;<\/li>\n\n\n\n<li>Medicare\u2019s Bilateral Surgery Indicator for the procedural code is 0, 2, or 9.&nbsp;<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Understand That Commercial Payers May Have Their Own Rules&nbsp;<\/strong><\/h3>\n\n\n\n<p>While we have stated the dos and don\u2019ts for appending modifier 50 in regard to Medicare billing rules and guidelines, please understand that this may vary across commercial payers. Each insurance payer has its distinct coding guidelines and reimbursement policies.&nbsp;<\/p>\n\n\n\n<p>So, while they may allow you to bill some procedures bilaterally for increased payment, usage of modifier 50 may be discouraged with other CPT codes. Therefore, we recommend thoroughly reviewing the payer\u2019s contract terms, coding manuals, and billing guidelines before claim creation and submission to avoid payment delays and denials.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Increase the Billed Amount to 150% of the Fees on the Claim&nbsp;<\/strong><\/h3>\n\n\n\n<p>The <a href=\"https:\/\/www.aapc.com\/blog\/24298-choose-a-surgical-modifier-50-51-or-59\/?srsltid=AfmBOorspZ2xmJ5yn0wQoh5oaGCzRUWMTTKnnStjR-Uu-rckJ0SyOpnl\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">American Academy of Professional Coders<\/a> (AAPC) advises that you should always increase the billed amount to 150% of the standard fees (a rise of 50% from the usual 100% rate) to ensure accurate reimbursement collection. They explain that Medicare does not increase this amount on its own, so you will have to do the math and enter the correct values.&nbsp;<\/p>\n\n\n\n<p>For example, if the standard fee for the unilateral procedure was $1,000 (charged at 100% of the reimbursement rate), then with the modifier 50 and performed bilaterally, the billed amount on the claim form should be $1,500 (charged at 150% of the reimbursement rate).&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Append<\/strong><strong> Modifier 50<\/strong><strong> on a Single Claim Line&nbsp;<\/strong><\/h3>\n\n\n\n<p>When filling out the paper or electronic claim form, enter this modifier on the same claim line as that of the appropriate unilateral CPT code. Moreover, you should report 1 unit in one unit field of that claim line. So, your entry should appear like this \u201820550-50 x1\u2019, where:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>20550<\/strong> is the surgery CPT code&nbsp;<\/li>\n\n\n\n<li><strong>-50<\/strong> is the payment modifier&nbsp;<\/li>\n\n\n\n<li><strong>x1<\/strong> is 1 unit of the service<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Summary<\/strong><\/h2>\n\n\n\n<p>Here is a quick recap of what we covered in our ultimate guide to appending modifier 50. First, we told you what the modifier indicates and its effect on the reimbursement rate. Second, we discussed some real-world scenarios where it is applicable, such as bilateral removal of ovaries or fallopian tubes, bilateral administration of nerve blockers, and bilateral probing of tear ducts. Lastly, we tried to educate you on the appropriate usage of this modifier and the billing rules you should follow when appending it, like only using it when the bilateral surgery indicators are 1 and 3.&nbsp;<\/p>\n\n\n\n<p>However, the simplest way to avoid all the fuss and collect accurate reimbursements each time is to <strong><a href=\"https:\/\/medibillmd.com\/services\/medical-coding-services\" target=\"_blank\" data-type=\"link\" data-id=\"https:\/\/medibillmd.com\/services\/medical-coding-services\" rel=\"noreferrer noopener\">outsource medical coding<\/a><\/strong> to billing experts like MediBillMD. Their diverse team of AAPC-certified coders excels in procedural coding and modifier usage.\u00a0<\/p>\n\n\n\n<p class=\"has-text-align-center has-text-color has-link-color has-large-font-size wp-elements-abb47e80fabc22046fdcb7a89e86f1a7\" style=\"color:#045cb4;margin-bottom:var(--wp--preset--spacing--30)\"><strong>Frequently Asked Questions<\/strong><\/p>\n\n\n<div class=\"wp-block-uagb-faq uagb-faq__outer-wrap uagb-block-6a7fb1d5 uagb-faq-icon-row-reverse uagb-faq-layout-accordion uagb-faq-expand-first-true uagb-faq-inactive-other-true uagb-faq__wrap uagb-buttons-layout-wrap uagb-faq-equal-height     \" data-faqtoggle=\"true\" role=\"tablist\"><script type=\"application\/ld+json\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@type\":\"FAQPage\",\"@id\":\"https:\\\/\\\/medibillmd.com\\\/blog\\\/modifier-50\\\/\",\"mainEntity\":[{\"@type\":\"Question\",\"name\":\"<strong>How does modifier 50 affect reimbursement?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Appending modifier 50 increases the reimbursement amount. Providers can bill a bilateral procedure at 150% of the standard fee. For example, if an eye surgery costs $1,000, the provider can bill $1,500 for performing it on both eyes.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Does Medicare accept modifier 50?\\u00a0<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. Medicare accepts modifier 50 with surgical CPT codes. However, you must follow its specific guidelines before appending it. For example, Medicare states that you should only report it with codes that have a Bilateral Surgical (BILAT SURG) Indicator 1 or 3.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can modifiers 50 and 51 be used together?\\u00a0<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. You cannot apply modifiers 50 and 51 to the same surgical CPT code. This is because both 50 and 51 are payment modifiers and mutually exclusive. You should use either 50 or 51 based on the situation and explain the specificity of the procedure. Moreover, Medicare advises against using modifier 51 as its processing system automatically adds the modifier to the CPT code as appropriate.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can modifiers 50 and 59 be used together?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Modifiers 50 and 59 should not be reported on the same line because 50 indicates a bilateral procedure, whereas 59 reports a separate\\\/distinct procedure or service. Again, both are payment modifiers and mutually exclusive. However, modifier 59 can be used with a bilateral service on the same claim form if the coding supports separate payment for a distinct procedure (e.g., injections) and a comprehensive bilaterally performed surgery (e.g., breast surgery).\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can modifier 50 be added to HCPCS codes?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"According to the <a href=\\\"https:\\\/\\\/www.facs.org\\\/media\\\/dcolbll4\\\/2013_10_bilateral.pdf\\\" target=\\\"_blank\\\" rel=\\\"noreferrer noopener nofollow\\\">American College of Surgeons<\\\/a>, you cannot add this modifier to HCPCS codes because this coding system uses modifiers LT and RT to indicate the side on which the service (e.g., injection administration) was performed. However, according to the <a href=\\\"https:\\\/\\\/www.cms.gov\\\/medicare-coverage-database\\\/view\\\/article.aspx?articleid=52848\\\">CMS\\u2019s s<\\\/a><a href=\\\"https:\\\/\\\/www.cms.gov\\\/medicare-coverage-database\\\/view\\\/article.aspx?articleid=52848\\\" target=\\\"_blank\\\" rel=\\\"noreferrer noopener nofollow\\\">p<\\\/a><a href=\\\"https:\\\/\\\/www.cms.gov\\\/medicare-coverage-database\\\/view\\\/article.aspx?articleid=52848\\\">ecific coding guidelines<\\\/a>, modifier 50 should not be appended with HCPCS codes J0585-J0589 as these Botox injections for cosmetic purposes are already bilateral and administered on both sides. It does not mention the remaining HCPCS codes.\\u00a0\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can I append modifier 50 to 20550?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. As the <a href=\\\"https:\\\/\\\/www.cms.gov\\\/medicare-coverage-database\\\/view\\\/article.aspx?articleId=59488&amp;ver=4\\\" target=\\\"_blank\\\" rel=\\\"noreferrer noopener nofollow\\\">CMS<\\\/a> has advised, you can append this modifier with musculoskeletal system surgery code 20550. However, you cannot report it with CPT codes 20551 or 20612.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can CPT 20610 be billed with modifier 50?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. You can add modifier 50 to the CPT code 20610 to explain bilateral aspiration or injection on a subacromial bursa or joint. However, we advise following the specific insurance carrier\\u2019s billing and coding guidelines for clean claim submission.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can CPT code 52005 be billed with modifier 50?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Medicare identifies CPT code 52005 with the bilateral surgery indicator \\u20180\\u2019, denoting that the cystourethroscopy on the bladder, urethra, and ureteric pelvis is inherently bilateral and performed on both sides. Hence, modifier 50 cannot be used with this CPT code for a 150% payment.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can CPT code 64455 be billed with a 50 modifier?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. CPT code 64455 is a bilateral eligible code and can be billed with modifier 50 to indicate that the steroid or anesthetic injection was administered on both feet to treat Morton's neuroma.\\u00a0\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can I use a 50 modifier with 63047?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. You cannot use modifier 50 with this CPT code because 63047 includes the words \\u201cunilateral or bilateral\\u201d in its description. Therefore, it is inherently a bilateral laminectomy code (because the CMS has assigned this procedure a bilateral indicator \\u20182\\u2019) and includes payment for both sides of the vertebra.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can I use modifier 50 with 64415?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. You can use modifier 50 with CPT code 64415 to explain to the payer that bilateral injections were administered into the brachial plexus area for nerve blocking. However, you must note that the code\\u2019s description includes the text \\u201cone or more injections during a single procedure\\u201d. So, depending on the insurance payer\\u2019s policies, you may or may not be reimbursed for the second injection.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can you use modifier 50 on 76882?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. You can append modifier 50 with CPT code 76882 to indicate that the real-time diagnostic imaging was performed on nonvascular structures of both extremities.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can you use modifier 50 with 97606?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. You should not use this modifier with CPT code 97606. Typically, payment modifier 59 is appended with code 97606 to indicate that this negative pressure wound therapy is separate and distinct from another procedure performed on the same day. Moreover, Medicare advises the use of modifiers RT or LT to indicate which side the controlled subatmospheric pressure was applied. However, please note that coding guidelines vary from payer to payer.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can you append modifier 50 on CPT 61867?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Many payers consider code 61867 a unilateral or bilateral deep brain stimulator procedure for patients suffering from dementia, Parkinson's, Alzheimer's, etc. So, if that is the case with the payer you are billing to, using modifier 50 will result in denial because the fee schedule includes payment for a bilateral procedure.\\u00a0\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can you bill 52332 with a 50 modifier?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. Medicare and most commercial payers accept modifier 50 with CPT code 52332 if cystourethroscopy with insertion of indwelling ureteral stent was performed bilaterally on both ureters.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can you bill CPT 58661 with modifier 50?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. You can bill CPT code 58661 with modifier 50 to alert the payer that a laparoscopic procedure was performed on both ovaries or fallopian tubes. It is because Medicare\\u2019s Bilateral Surgery Indicator for code 58661 is \\u20181\\u2019, so it can be billed bilaterally with this modifier for a 150% reimbursement amount.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can you bill CPT 64400 with modifier 50?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. You can bill CPT code 64400 with this modifier because CMS\\u2019s Bilateral Surgery Indicator for this code is \\u20181\\u2019. It means that if the provider administered an anesthetic agent or steroid close to each branch of the fifth cranial nerve bilaterally during the same encounter, this modifier is applicable.\"}},{\"@type\":\"Question\",\"name\":\"<strong>Can you bill for CPT 61867 with modifier 50?<\\\/strong>\",\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. Modifier 50 can be appended for CPT code 61867 because deep brain stimulator procedures are inherently unilateral or bilateral. Moreover, CMS\\u2019s Bilateral Surgery Indicator for code 61867 is \\u20181\\u2019, denoting \\u201cbilateral surgery rule applies\\u201d.\"}}]}<\/script><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-9d7f5ed0 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>How does modifier 50 affect reimbursement?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Appending modifier 50 increases the reimbursement amount. Providers can bill a bilateral procedure at 150% of the standard fee. For example, if an eye surgery costs $1,000, the provider can bill $1,500 for performing it on both eyes.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-c556ad62 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Does Medicare accept modifier 50?\u00a0<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. Medicare accepts modifier 50 with surgical CPT codes. However, you must follow its specific guidelines before appending it. For example, Medicare states that you should only report it with codes that have a Bilateral Surgical (BILAT SURG) Indicator 1 or 3.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-c15eaf00 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can modifiers 50 and 51 be used together?\u00a0<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>No. You cannot apply modifiers 50 and 51 to the same surgical CPT code. This is because both 50 and 51 are payment modifiers and mutually exclusive. You should use either 50 or 51 based on the situation and explain the specificity of the procedure. Moreover, Medicare advises against using modifier 51 as its processing system automatically adds the modifier to the CPT code as appropriate.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-8dac12ab \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can modifiers 50 and 59 be used together?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Modifiers 50 and 59 should not be reported on the same line because 50 indicates a bilateral procedure, whereas 59 reports a separate\/distinct procedure or service. Again, both are payment modifiers and mutually exclusive. However, modifier 59 can be used with a bilateral service on the same claim form if the coding supports separate payment for a distinct procedure (e.g., injections) and a comprehensive bilaterally performed surgery (e.g., breast surgery).<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-66ae0c5a \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can modifier 50 be added to HCPCS codes?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>According to the <a href=\"https:\/\/www.facs.org\/media\/dcolbll4\/2013_10_bilateral.pdf\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">American College of Surgeons<\/a>, you cannot add this modifier to HCPCS codes because this coding system uses modifiers LT and RT to indicate the side on which the service (e.g., injection administration) was performed. However, according to the <a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/article.aspx?articleid=52848\" rel=\"nofollow noopener\" target=\"_blank\">CMS\u2019s s<\/a><a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/article.aspx?articleid=52848\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">p<\/a><a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/article.aspx?articleid=52848\" rel=\"nofollow noopener\" target=\"_blank\">ecific coding guidelines<\/a>, modifier 50 should not be appended with HCPCS codes J0585-J0589 as these Botox injections for cosmetic purposes are already bilateral and administered on both sides. It does not mention the remaining HCPCS codes.\u00a0<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-9176f50a \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can I append modifier 50 to 20550?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. As the <a href=\"https:\/\/www.cms.gov\/medicare-coverage-database\/view\/article.aspx?articleId=59488&amp;ver=4\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">CMS<\/a> has advised, you can append this modifier with musculoskeletal system surgery code 20550. However, you cannot report it with CPT codes 20551 or 20612.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-65c0b72c \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can CPT 20610 be billed with modifier 50?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. You can add modifier 50 to the CPT code 20610 to explain bilateral aspiration or injection on a subacromial bursa or joint. However, we advise following the specific insurance carrier\u2019s billing and coding guidelines for clean claim submission.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-240c2c16 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can CPT code 52005 be billed with modifier 50?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Medicare identifies CPT code 52005 with the bilateral surgery indicator \u20180\u2019, denoting that the cystourethroscopy on the bladder, urethra, and ureteric pelvis is inherently bilateral and performed on both sides. Hence, modifier 50 cannot be used with this CPT code for a 150% payment.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-42fc5d5a \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can CPT code 64455 be billed with a 50 modifier?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. CPT code 64455 is a bilateral eligible code and can be billed with modifier 50 to indicate that the steroid or anesthetic injection was administered on both feet to treat Morton&#8217;s neuroma.\u00a0<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-a0d3910c \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can I use a 50 modifier with 63047?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>No. You cannot use modifier 50 with this CPT code because 63047 includes the words \u201cunilateral or bilateral\u201d in its description. Therefore, it is inherently a bilateral laminectomy code (because the CMS has assigned this procedure a bilateral indicator \u20182\u2019) and includes payment for both sides of the vertebra.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-11029a5e \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can I use modifier 50 with 64415?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. You can use modifier 50 with CPT code 64415 to explain to the payer that bilateral injections were administered into the brachial plexus area for nerve blocking. However, you must note that the code\u2019s description includes the text \u201cone or more injections during a single procedure\u201d. So, depending on the insurance payer\u2019s policies, you may or may not be reimbursed for the second injection.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-7c10fcf4 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can you use modifier 50 on 76882?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. You can append modifier 50 with CPT code 76882 to indicate that the real-time diagnostic imaging was performed on nonvascular structures of both extremities.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-d675e167 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can you use modifier 50 with 97606?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>No. You should not use this modifier with CPT code 97606. Typically, payment modifier 59 is appended with code 97606 to indicate that this negative pressure wound therapy is separate and distinct from another procedure performed on the same day. Moreover, Medicare advises the use of modifiers RT or LT to indicate which side the controlled subatmospheric pressure was applied. However, please note that coding guidelines vary from payer to payer.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-c814e936 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can you append modifier 50 on CPT 61867?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Many payers consider code 61867 a unilateral or bilateral deep brain stimulator procedure for patients suffering from dementia, Parkinson&#8217;s, Alzheimer&#8217;s, etc. So, if that is the case with the payer you are billing to, using modifier 50 will result in denial because the fee schedule includes payment for a bilateral procedure.\u00a0<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-c0f67a06 \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can you bill 52332 with a 50 modifier?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. Medicare and most commercial payers accept modifier 50 with CPT code 52332 if cystourethroscopy with insertion of indwelling ureteral stent was performed bilaterally on both ureters.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-27d177fc \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can you bill CPT 58661 with modifier 50?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. You can bill CPT code 58661 with modifier 50 to alert the payer that a laparoscopic procedure was performed on both ovaries or fallopian tubes. It is because Medicare\u2019s Bilateral Surgery Indicator for code 58661 is \u20181\u2019, so it can be billed bilaterally with this modifier for a 150% reimbursement amount.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-12d2f85d \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can you bill CPT 64400 with modifier 50?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. You can bill CPT code 64400 with this modifier because CMS\u2019s Bilateral Surgery Indicator for this code is \u20181\u2019. It means that if the provider administered an anesthetic agent or steroid close to each branch of the fifth cranial nerve bilaterally during the same encounter, this modifier is applicable.<\/p><\/div><\/div><div class=\"wp-block-uagb-faq-child uagb-faq-child__outer-wrap uagb-faq-item uagb-block-f465905c \" role=\"tab\" tabindex=\"0\"><div class=\"uagb-faq-questions-button uagb-faq-questions\">\t\t\t<span class=\"uagb-icon uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M432 256c0 17.69-14.33 32.01-32 32.01H256v144c0 17.69-14.33 31.99-32 31.99s-32-14.3-32-31.99v-144H48c-17.67 0-32-14.32-32-32.01s14.33-31.99 32-31.99H192v-144c0-17.69 14.33-32.01 32-32.01s32 14.32 32 32.01v144h144C417.7 224 432 238.3 432 256z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<span class=\"uagb-icon-active uagb-faq-icon-wrap\">\n\t\t\t\t\t\t\t\t<svg xmlns=\"https:\/\/www.w3.org\/2000\/svg\" viewBox= \"0 0 448 512\"><path d=\"M400 288h-352c-17.69 0-32-14.32-32-32.01s14.31-31.99 32-31.99h352c17.69 0 32 14.3 32 31.99S417.7 288 400 288z\"><\/path><\/svg>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t<span class=\"uagb-question\"><strong>Can you bill for CPT 61867 with modifier 50?<\/strong><\/span><\/div><div class=\"uagb-faq-content\"><p>Yes. Modifier 50 can be appended for CPT code 61867 because deep brain stimulator procedures are inherently unilateral or bilateral. Moreover, CMS\u2019s Bilateral Surgery Indicator for code 61867 is \u20181\u2019, denoting \u201cbilateral surgery rule applies\u201d.<\/p><\/div><\/div><\/div>\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Left side, right side. One side, two sides. One claim line, separate claim line. Gosh! If your medical coding and [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":2414,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_eb_attr":"","content-type":"","_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[16],"tags":[],"class_list":["post-2413","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-modifiers"],"uagb_featured_image_src":{"full":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/what-is-modifier-50-67728409d4c70.webp",1200,720,false],"thumbnail":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/what-is-modifier-50-67728409d4c70-150x150.webp",150,150,true],"medium":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/what-is-modifier-50-67728409d4c70-300x180.webp",300,180,true],"medium_large":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/what-is-modifier-50-67728409d4c70-768x461.webp",768,461,true],"large":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/what-is-modifier-50-67728409d4c70-1024x614.webp",1024,614,true],"1536x1536":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/what-is-modifier-50-67728409d4c70.webp",1200,720,false],"2048x2048":["https:\/\/medibillmd.com\/blog\/wp-content\/uploads\/2024\/12\/what-is-modifier-50-67728409d4c70.webp",1200,720,false]},"uagb_author_info":{"display_name":"Fred Allen","author_link":"https:\/\/medibillmd.com\/blog\/author\/fred-allen\/"},"uagb_comment_info":0,"uagb_excerpt":"Left side, right side. One side, two sides. One claim line, separate claim line. Gosh! If your medical coding and [&hellip;]","_links":{"self":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/posts\/2413","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/comments?post=2413"}],"version-history":[{"count":0,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/posts\/2413\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/media\/2414"}],"wp:attachment":[{"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/media?parent=2413"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/categories?post=2413"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medibillmd.com\/blog\/wp-json\/wp\/v2\/tags?post=2413"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}