Health Information Management

Q/A: Bilateral code changes

APCs Insider, May 4, 2012

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Q: Did CMS revise the list of bilateral codes in the OPPS April update?

A: Yes. CMS removed CPT® code 36000 (introduction of needle or intracatheter, vein) from the conditionally-bilateral list. CMS also removed these two codes from the inherently-bilateral list and added them to the conditionally-bilateral list:

  • 64613: Chemodenervation of muscle(s): muscle(s) innervated by facial nerve
  • 64614: Chemodenervation of muscle(s): cervical spinal muscle(s)

When a provider performs a conditionally bilateral service bilaterally, coders must append modifier -50 (bilateral procedure) to the code. If a code is inherently bilateral, coders should not append modifier -50 when the service is performed bilaterally.



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