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).

The current coding manual states that the intent of this modifier is to be appended to the appropriate unilateral procedure code as a one-line entry on the claim form indicating the procedure was performed bilaterally (two times).

An example of the appropriate use of Modifier 50:

When using Modifier 50 to indicate a procedure was performed bilaterally, the modifiers LT (Left) and RT (Right) should not be billed on the same service line.  Modifiers LT or RT should be used to identify which one of the paired organs were operated on.  Billing procedures as two lines of service using the left (LT) and right (RT) modifiers is not the same as identifying the procedure with Modifier 50.  Modifier 50 is the coding practice of choice when reporting bilateral procedures.  When determining reimbursement, the Blue Cross and Blue Shield of Texas/HMO Blue Texas Professional Multiple Surgery Pricing Guidelines apply.  These guidelines are located on our provider Web site at www.bcbstx.com/provider/pdf/multiplesurgerylogic.pdf.