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Hi, my surgeons want to bill 21031 bilaterally but I am not seeing that a 50 modifier can be used on this cpt code. Can you help?
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Hi Guest!
21031 - Excision of torus mandibularis
Yes I don't show that the modifier 50 for bilateral procedure is necessary for this code, although some medical insurers may accept it. Since the description specifies location as mandible, no need for bilateral since there is only 1 mandible in the body!
If the procedure was more involved/difficult/extensive than the norm, you may instead consider modifier 22 for "increased procedural service"
Hope this helps!
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Rank: Guest
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Hello! So if my doctor removes tori on both sides do we bill it out twice? Or just once?
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Rank: Administration
Joined: 11/21/2012(UTC)
Posts: 1,732
Thanks: 39 times
Was thanked: 51 time(s) in 51 post(s)
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Hi Guest!
You will bill out 1 unit of it. If the procedure is more complicated/difficult/time consuming that "normal", you can consider the modifier 22 for "increased procedural service".
Hope this helps!
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Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 2,248
Was thanked: 16 time(s) in 15 post(s)
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Originally Posted by: Guest  Hi, my surgeons want to bill 21031 bilaterally but I am not seeing that a 50 modifier can be used on this cpt code. Can you help? Coding for bilateral procedures can be confusing. Many payers accept CPT modifier 50 as an indicator of a bilateral procedure, but they differ in how they apply it to their coding and payment policies. and regarding your issue, there is no need for modifier-50 for bilateral. Merci: Return policy
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