What is a bilateral indicator?

What is a bilateral indicator?

The bilateral indicator “B” column shows that: If two of the same services were performed bilaterally, the services should be billed on two separate lines with 1 unit apiece, the 50 modifier and the appropriate repeat modifier on one of the lines. CPT 28340 has bilateral indicator of 0.

What does Status Indicator E1 mean?

Status Indicators E1 is used for items and services that are: Not covered by any Medicare outpatient benefit category. Statutorily excluded by Medicare. Not reasonable and necessary.

How are bilateral procedures paid?

Bilateral procedures are procedures performed on both sides of the body during the same operative session. Medicare makes payment for bilateral procedures based on lesser of the actual charges or 150 percent of the Medicare Physician Fee Schedule (MPFS) amount when the procedure is authorized as a bilateral procedure.

What is a bilateral procedure?

United Healthcare. Definition: Bilateral procedures are those that can be performed on both sides of the body during the same session by the same individual physician.

What is the bilateral procedure rule?

CMS defines a bilateral service as one in which the same procedure is performed on both sides of the body during the same operative session or on the same day.

What does SI mean for Medicare?

• “Status Indicator” (SI): assigned by CMS to HCPCS codes to indicate payment.

Who can bill G0463?

HCPCS Code G0463 is used for all FACILITY evaluation and management visits, regardless of the intensity of service provided.

How do you bill bilateral mastectomy?

For example, if you are billing for a bilateral mastectomy, you would report CPT code 19303 (Mastectomy, simple, complete) with the modifier. You would report the service as a single line item: 19303 50.

Is CPT 69436 bilateral?

In this example, CPT® code 40701 (plastic repair of cleft lip/nasal deformity; primary bilateral, one stage procedure) is the primary procedure and CPT code 69436 (tympanostomy [requiring insertion of ventilating tube], general anesthesia) is the secondary procedure. Both procedures are bilateral.