Question:
The patient had a right breast ultrasound, and we billed CPT® code 76641 with modifier –RT. The insurer denied this claim due to the modifier. Doesn’t the breast ultrasound require a modifier?
Answer:
Unfortunately, modifier use is payer-specific. Each payer makes its own rules about how it wants modifiers assigned. In such a case, you would not use modifier -RT or -LT, if you are performing only one side ultrasound. If you are performing bilateral breast ultrasound, then report the appropriate code with modifier -50.
CPT® is a registered trademark of the American Medical Association.
