Bilateral surgical procedure modifier – 50

50 Bilateral Procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same operative session should be identified by adding the modifier 50 to the appropriate five digit code.

Report such procedures as a single line item with a unit of 1. For example, when procedure code 19180 ( Mastectomy, simple, complete) is performed bilaterally, report the service as 1918050.

If a procedure is identified by the terminology as bilateral ( or unilateral or bilateral), do NOT report the procedure code with modifier 50. For example, procedure code 68810 to 68815, ( probing of nasolacrimal duct, with or without irrigation, unilateral or bilateral) includes terminology which indicates the procedure is performed either unilaterally or bilaterally. Therefore it’s not appropriate to report this modifier with this code.

Additionally some procedure codes, i.e., 52000 ( Cystourethroscopy, separate procedure) should NOT be reported with the 50 modifier since anatomy does not permit this procedure to be performed bilaterally.