Medical Billing Forum

Coding => Coding => Topic started by: dfranklin on May 30, 2009, 04:48:52 AM

Title: Bilateral Modifers and different regions of extremities
Post by: dfranklin on May 30, 2009, 04:48:52 AM
My Chiro physician ask me to look up bilateral modifiers for him. He said he often adjust extremities B/L and wants to report them correctly.

Also, how does he distinguish different anatomical regions of extremities being adjusted so that the payors aren't confused with 98943 reported 2x on the same OV?   Is that modifier 51 on the 2nd one and not on the 1st?

Thanks!
Title: Re: Bilateral Modifers and different regions of extremities
Post by: Pay_My_Claims on May 30, 2009, 07:15:28 AM
modifier 51 is for multiple procedures....you have RT and LT modifiers this distinguishes which side you performed the procedure on. Bilateral you can use modifier 50
Title: Re: Bilateral Modifers and different regions of extremities
Post by: dfranklin on May 30, 2009, 03:03:43 PM
So for multiple procedures say 98943 (x2) do I use modifier 51 on both or just the 2nd one?

Bilateral he can use 50 what modifiers are for RT & LT?

Thanks for your help!  It is much appreciated.
Title: Re: Bilateral Modifers and different regions of extremities
Post by: Michele on May 30, 2009, 09:13:44 PM
If he does both sides he would use the 50 modifier, if he did one or the other he would use RT or LT.

I didn't think chiros could treat extremities.   ???

Michele
Title: Re: Bilateral Modifers and different regions of extremities
Post by: Pay_My_Claims on May 30, 2009, 10:49:33 PM
LOL, I have no idea, I just knew the modifier for bilateral, and the one that distinguishes rt/lt.
Title: Re: Bilateral Modifers and different regions of extremities
Post by: dfranklin on June 01, 2009, 12:32:44 PM
Thanks for the help and clarification.  I greatly appreciate it!
Title: Re: Bilateral Modifers and different regions of extremities
Post by: thatcuteblonde on June 01, 2009, 02:39:19 PM
98943 is an extremity adjustment code, many payers will not cover it and honestly, I've never seen a payer cover it with more than one unit, as it would definitely lean towards maintenance at that point, but you can bill it with a 50 modifier. 51 is usually used for CPT Codes that are classified as surgical.