03/07/2022

Denial for Billing for CPT 77077-Bilaterally

Okay, I did what you said for code 77077 bilaterally: I billed 1 unit, a doubled fee, and the 50 modifier, and received a MA130 rejection each time. Then I rebilled, with the 50, RT, and LT modifiers, and got the same rejections, along with N822. What gives?

Reviewing CMS’ MUE limitations on CPT code 77077, a provider is only allowed to bill this code once per day per patient, regardless, if they take multiple views on one side or both sides. As a result, in order to correct these denials, all patients should be charged for one unit of service with no modifiers (-LT, -RT, or -50). You should be reimbursed for these radiology studies if the charges are corrected for one unit of service. While unlikely, but modifier -59 can be used if a patient had multiple radiology services billed on the same DOS that might be considered inclusive to the bone/joint survey.