Radiology Question for the Week of December 16, 2024

Question:

When do we apply modifier 50 in 2025?

Answer:

Consider the following description to gain a clearer understanding of this modifier to use as needed. Bilateral Procedure: Unless otherwise identified in the listings, bilateral procedures that are performed at the same session should be identified by adding modifier 50 to the appropriate five-digit code or by use of the separate five digit modifier code 09950. Note that in the past, AMA stated that modifier 50 should not be used with the 7xxxx codes, but in 2010 they removed the word “operative” from the modifier 50 definition, thus making it allowable for the 7xxxx series. Modifier 50 is used as a payment, rather than informational, modifier. The addition of this modifier could affect payment depending on the procedure code and the BILAT SURG indicator on the Medicare Physician Fee Schedule (MPFS).

This question was answered in our Breast & Bone Density Procedure Coding Guide. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.