When coding for a bilateral procedure, which modifier is used?

The use of Modifier 50 is specifically designated for reporting bilateral procedures in coding. When a surgical procedure is performed on both sides of the body—such as a bilateral mastectomy or bilateral knee arthroscopy—this modifier indicates that the procedure was not just performed on one side but on both sides, which can affect payment and reimbursement procedures.

Applying Modifier 50 helps insurers and medical billing organizations recognize that the procedure encompassed both sides, ensuring the appropriate coding and reimbursement for the services rendered. It is essential for accurate representation of the clinical service provided, and it assists in preventing potential billing discrepancies.

Other modifiers, such as Modifier 51, generally indicate multiple procedures performed during the same session, and Modifier 27 indicates a distinct procedural service on the same day. Modifier 72 pertains to repeat procedures due to complications. These do not specifically address the situation of bilateral procedures, making Modifier 50 the correct choice.