01/03/2023

Correct Billing for Bilateral Venous Insufficiency with Ulcerations and Inflammation

For a patient that has bilateral venous insufficiency with ulcerations and inflammation, how would you bill for bilateral multilayer compression dressings. Medicare and some of the Medicare HMO plans have denying the claims. Should it be billed 29581, 2 units modifier 50 with icd 10 codes I87.331 and I87.332? Or Should it be billed with 2 line items, 29581 RT, 59 with I87.331, and 29581 LT with I87.332

When billing for a bilateral strapping to traditional Medicare and some Medicare Advantage plans (Empire Blue Cross, Humana, and United Healthcare), the bilateral service needs to be billed on one line item. When billing under a single line with modifier -50 for a bilateral procedure, it should only be billed with one unit of service with the fee doubled on the claim. When billing other Medicare plans, bilateral strappings should be billed on separate lines with the appropriate site modifier as you would to most other payers (commercial & Medicaid).