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  • Submit claim for bilateral capsulotomy on Medicare Part B patient

    Bilateral capsulotomy is performed on a Medicare Part B patient. How should the claim be submitted? 

    According to Medically Unlikely Edits (MUE) published April 2013, all bilateral surgical procedures should be submitted as a single line with modifier -50. In this example 66821 -50. Put a 1 in the unit field of the CMS 1500 form. Correct payment is 150 percent of the allowable. Other payers that don’t follow Part B might require two lines with modifiers -RT/-LT.