Ophthalmic Coding Specialist Practice Test

What is the modifier for a bilateral procedure according to CPT coding?

1. -57

2. -50

3. -78

4. -79

The correct answer is: -50

The modifier for a bilateral procedure according to CPT coding is -50. This modifier is used to indicate that a procedure was performed on both sides of the body during the same operative session. For example, if a patient undergoes cataract surgery in both eyes, the -50 modifier would be appended to the code to signify that it was a bilateral procedure. Utilizing this modifier allows for clarity in billing and ensures that insurance carriers can process claims appropriately, as they need to recognize that the service was performed on both sides to calculate payment accurately. The use of -50 streamlines the coding process, allowing practitioners to avoid duplicating codes for each side. The other modifiers mentioned, such as -57, -78, and -79, serve different purposes. For instance, -57 is usually applied to indicate a decision for surgery on the day before or the day of a major procedure, while -78 and -79 are used to indicate complications or unrelated procedures performed during the postoperative period.