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POLICYAccording to CPT, unless otherwise identified in the listings, bilateral procedures that are performed at the same operative session should be identified by adding modifier 50 to the appropriate five digit code. The use of modifier 50 is applicable only to services and/or procedures typically performed on both sides of the body (mirror image) during the same operative session. The intent of this modifier is to be appended to the appropriate unilateral codes as a one-line entry on the claim form indicated that the procedure was performed bilaterally. Procedures performed bilaterally are identified by adding modifier 50 to the procedure code.
To report a bilateral procedure to BCBSMS, the procedure performed should be repeated on the claim form with the modifier -50 appended to the second line with one (1) unit on each line.
For example, if billing 20610 bilaterally, the code should be reported as follows:
Line 1: 20610 with 1 unit
Line 2: 20610-50 with 1 unit
POLICY GUIDELINESThe coding guidelines outlined in Coding Policy should not be used in lieu of the Member's specific benefits plan language.
POLICY HISTORY11/2007: New Policy developed