Modifier 50: Indicates services subject to payment adjustment
See also
Other PFS Helpers:
switch_assistant_surgery(),
switch_co_surgeon(),
switch_diagnostic_imaging(),
switch_global_days(),
switch_multiple_procedure(),
switch_opps_indicator(),
switch_pctc_indicator(),
switch_status_description(),
switch_status_name(),
switch_supervision(),
switch_team_surgery()
Examples
switch_bilateral_surgery(c(0:3, "9"))
#> [1] "Adjustment does not apply. If reported with mod 50 or RT and LT, payment for the two sides is the lower of (a) total charge for both sides (b) 100% of fee schedule amount for a single code. Adjustment is inappropriate because (a) of physiology or anatomy, or (b) code description states it is a unilateral procedure and there is an existing code for the bilateral procedure."
#> [2] "Adjustment applies. If reported with bilateral modifier or twice on same day by any other means (with RT and LT mods, or with a 2 in the units field), base payment on lower of: (a) total charge for both sides or (b) 150% of fee schedule amount for a single code. If reported as bilateral procedure and reported with other procedure codes on same day, apply bilateral adjustment before applying any multiple procedure rules."
#> [3] "Adjustment does not apply. RVUs already based on procedure as a bilateral procedure. If reported with mod -50 or twice on same day by any other means, base payment on lower of (a) total charge for both sides, or (b) 100% of fee schedule for a single code."
#> [4] "Adjustment does not apply. If reported with mod 50 or for both sides on same day by any other means, base payment for each side or organ or site of paired organ on lower of (a) charge for each side or (b) 100% of fee schedule amount for each side. If reported as bilateral procedure and with other procedure codes on same day, determine fee schedule amount for a bilateral procedure before applying any multiple procedure rules. Services in this category are generally radiology procedures or other diagnostic tests which are not subject to the special payment rules for other bilateral surgeries."
#> [5] "Concept does not apply"