tci Outpatient Facility Coding Alert - 2014 Issue 5

Modifier Check: Ensure You're Coding Precisely With Modifiers 50 and 52

Tip: Fee schedules and payers help guide when you should report. As the name implies, modifiers modify a procedure /service or an item under certain circumstances to correctly code for the exact procedure/service provided. Reporting some modifiers can be tricky, which means incorrect coding can lead to denials or incorrect reimbursement. Read on for the lowdown on two common modifiers for outpatient/ASC procedures: modifier 50 (Bilateral procedure) and modifier 52 (Reduced services).  Only Consider Modifier 50 for Same-Session Services  You can sometimes use modifier 50 to report bilateral procedures that the physician performs at the same treatment session...

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