50 - JE Part B
Modifier 50
Bilateral Procedure
Instructions
When performing a procedure on bilateral body parts, append payment modifier 50 to the appropriate code performed at the same session. The bilateral adjustment is inappropriate for (a) physiology or anatomy codes or (b) code descriptor that specifically states it is a unilateral procedure and there is an existing bilateral procedure code.
Correct Use
- One line appending modifier 50 or RT and LT using one unit of service
- See Bilateral Surgery Rules within Medicare Physician Fee Schedule (MPFS) Indicator Descriptions
Incorrect Use
- Inappropriate to apply an already "bilateral description" code
- Do not append to procedures for midline organs such as bladder, uterus, esophagus or nasal septum
- Inappropriate to report when performed on different areas of same side of body
Claim Coding Example
| Treatment Description | CPT/Modifier |
|---|---|
| Total Knee Arthroplasty | 27447 50 |
Resources
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 23, Section 50.6
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 40.7
Last Updated Dec 09 , 2023
