Beginning April 1, 2012, Blue Cross and Blue Shield of Texas (BCBSTX) will pursue overpayments it made for claims wrongly billed with modifier 50. Modifier 50 denotes a bilateral procedure (diagnostic, radiological, or surgical) performed on both sides at the same operative session. You should:
Submit modifier 50 only on those procedures that can be performed bilaterally.
- Identify bilateral procedures performed at the same operative session by adding a modifier 50 to the appropriate five-digit CPT code.
- Not use modifier 50 with procedures identified by their terminology as either “bilateral” or “unilateral or bilateral.”
- Report one unit, do not use modifiers RT and LT, and do not submit two line items.
To view information on BCBSTX’s multiple surgery pricing, sign in to its website and go to All Product News, Multiple Surgery — Prof.
Published March 16, 2012
TMA Practice E-Tips main page