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Ophthalmology Coding: RT/LT or Modifier 50?

Posted on 03. Apr, 2009 by in Hot Coding Topics

Prevent Uni-Bi Reporting Errors With This Expert Insight

Don’t let tricky prefixes stand in the way of maximum reimbursement for your practice. Read on to learn when you can expect deserved double payment for a service and how to ethically make the most of modifiers.

ON-DEMAND AUDIO: Deborah Grider takes the mystery out of global surgical packages and correct modifier usage.

Dispel Prefix Confusion

The most common mistake new ophthalmology coders make is tripping over the unilateral-bilateral conundrum. Here is the breakdown:

Unilateral means there is a 100 percent allowance per eye. In effect, two unilateral procedures results in a payment equal to 200 percent of the fee, explained Raequell Duran, CPC, president of Practice Solutions, a coding, compliance, and reimbursement consulting firm based in Santa Barbara, Calif., at The Coding Institute’s December conference in Orlando.

Bilateral means there is...

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