Present your AHA Coding Clinic for HCPCS article ( I posted the article below) and explain why this resource would be beneficial to a coder.

Question 1

Our facility coders would like clarification on theproper usage of modifier 50 when attaching it to a CPT code. Ourdepartment has been using this modifier when a bilateral procedure(i.e., one done on both sides of the body) is performed. The definitionthat we use for bilateral comes strictly from the CPT coding book andother coding guidelines. We were recently told that our HIM departmentis using this modifier incorrectly. Can you clarify this?

Answer

The term "bilateral" denotes of, relating to, oraffecting the right and left sides of the body or the right and leftmembers of paired organs. CMS states that modifier 50 applies to anybilateral procedure performed on both sides at the same session.

Modifier 50 may not be used to report surgicalprocedures identified by their terminology as "bilateral" or to reportsurgical procedures identified by their terminology as "unilateral orbilateral".

Modifier 50 is used to report bilateral proceduresthat are performed at the same operative session and reported as asingle line item by definition as a unilateral service. This isconsistent with the definitions from the CPT coding book and the CPTAssistant.

Be alert to the full CPT code description. If a bodysite or procedure is identified as singular or plural, for example"(s)," generally, modifier 50 would not be appropriate in these cases.