50 Modifier Bilateral Procedure. Modifier 50 represents that the procedure was performed bilaterally. To report bilateral services, bill the procedure with the 50 modifier and a unit of one in the days/units field or electronic equivalent.
Example: 29870-50 $1,000 Units = 1
The billed charge should reflect a bilateral procedure amount if the procedure was performed bilaterally.
Note: Please refer to your current MPFSDB to determine whether a 50 modifier may be added on the procedure code being used.
Example: The following example demonstrates pricing of bilateral services billed.
Code Allowed Bilaterally on MPFSDB (50 Modifier)Unilateral Allowed Amount $ Final Allowance$
29870-50 Yes 365.31 x 150% = 547.96 (bilateral) 547.96 x 80%
Example: The following example demonstrates multiple surgery pricing logic as it is applies to bilateral surgeries.
Code Indicator 50 Modifier Unilateral Allowed Amount $ Ranking Final Allowance $
29870-50 2 Yes 365.31 x 150% = 547.96 (bilateral) 100% 547.96 x 80%
29345-50 2 Yes 115.04 x 150% = 172.56 (bilateral) 50% 86.28 x 80%
Medicare Guideline posts
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Top Medicare billing tips
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee...
CPT CODE and description 90460 - Immunization administration through 18 years of age via any route of administration, with counseling by ...
CPT CODE and Description 97001 - Physical therapy evaluation Average fee payment $70 - $80 97002 - Physical therapy re-evaluation Ave...
CPT CODE and Description 90785 - Interactive complexity (List separately in addition to the code for primary procedure) 90791 - Psychi...
This post has Most used J code list and we are constantly updating with example . If you are looking particular J code, use search button. ...
Flow Cytometry is a highly complex process by which blood, body fluids, bone marrow and tissue can be examined. It provides important immun...
Here is the big list of Medical terminology abbreviation @—at A & P—anatomy and physiology ab—abortion abd—abdominal ABG—arterial ...
Place of Service: A two-digit code used on health care professional claims to indicate the setting in which a service was provided. Place...
Complete Blood Count (CBC) Testing A complete blood count consists of measuring a blood specimen for levels of hemoglobin, hematocrit, red...
procedure code and description 93922 LIMITED BILATERAL NONINVASIVE PHYSIOLOGIC STUDIES OF UPPER OR LOWER EXTREMITY ARTERIES, (EG, FOR LOW...