What is the bilateral procedure rule?

Ccms

Updated: 4th December 2019

Modifier 50 applies to bilateral procedures performed on both sides of the body during the same operative session. When a procedure is identified by the terminology as bilateral or unilateral, the 50 modifier is not reported.

Similarly, what is a bilateral code?

Definition: Bilateral procedures are those performed during the same operative session by the same physician in either separate operative areas (e.g., hands, feet, legs, arms, ears), or one (same) operative area (e.g., nose, eyes, breasts).

What is the modifier for a bilateral procedure?

CPT Modifier 50 Bilateral Procedures – Professional Claims Only. Modifier 50 is used to report bilateral procedures that are performed during the same operative session by the same physician in either separate operative areas (e.g. hands, feet, legs, arms, ears), or one (same) operative area (e.g. nose, eyes, breasts).

What is a 25 modifier used for?

Modifier 25 (significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the procedure or other service) is the most important modifier for pediatricians in Current Procedural Terminology (CPT®).
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