General Question for the Week of January 7, 2019

Question:

What modifier should be used to report bilateral surgical procedures?

Answer:

Practitioners and outpatient hospitals report bilateral surgical procedures with modifier 50 and one unit of service (UOS) on a single claim line unless the code descriptor defines the procedure as “bilateral.” In that case, the one unit of service (UOS) would be reported without modifier 50. MUE values for surgical procedures that may be performed bilaterally are based on this reporting requirement, according to the Centers for Medicare & Medicaid Services. Note that this reporting requirement does not apply to an ambulatory service.