Modifier 50 is used to record bilateral procedures done by the same physician over the same surgical session in either distinct operative area (e.g., hands, feet, legs, arms, ears) or one (same) operative area (e.g., nose, eyes, breasts). According to the current coding manual, this modification is intended to be added to the appropriate unilateral procedure code as a one-line notation on the claim form stating that the surgery was conducted bilaterally (two times).
Modifiers LT (Left) and RT (Right) must not be charged on the same service area when utilizing Modifier 50 to signify a procedure was conducted bilaterally. To specify which of the linked organs was operated on, apply the modifiers LT or RT.
Appropriate use
When a method is conducted bilaterally in a single session, and the Medicare Physician Fee Schedule BILAT SURG indication is 1:
- Submit codes across one line with a BILAT SURG indicator of 1, adding modifier 50, and submitting one unit of service.
When surgery is performed bilaterally in a single session, and the Medicare Physician Fee Schedule (MPFS) BILAT SURG indication is 3: - Send codes with a BILAT SURG 3 on a single line, followed by either modifier 50 and one unit of service (UOS).
- Input codes on a single line with two UOS (the RT/LT modifiers are optional).
- Send on two lines of connection, one with RT and one with LT, each with one UOS.
Inappropriate use
When conducting the activity on different locations of the same body side, mention this modification.
- The BILAT SURG indication is either 0 or 2, or 9.
- Use the RT and LT modifiers when eliminating a lesion on the right arm and one on the left arm.
- Modifier 50 should not be used for multiple treatments on the same organ, such as the skin.
- A procedure code stated in its CPT description is bilateral, unilateral, or bilateral.
- Reporting a bilateral treatment on two service lines by inserting modifier 50 to the additional line of service is not permitted.
