What is the correct use of modifiers when reporting bilateral or bilateral primary procedures for lower extremity revascularization procedures?
First, note that the lower extremity revascularization codes are unilateral in nature. Should bilateral primary procedures be performed, modifier 50 must be applied. If performing bilateral procedures, additional services described by add-on codes should be reported twice, with modifier 59 or XS to denote that different legs are being treated. Coders may be tempted to apply modifier 50 to these add-on codes. However, it is critical to remember that modifier 50 cannot be reported with add-on codes. When different treatments in either the same or different vascular territories are performed in either the same leg or each leg, append modifier 59 or XS to denote distinct procedures.
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