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We billed 21422 as qty 2 with modifier 50 since it was a bilateral procedure but the insurance came back stating the procedure code is inconsistent with the modifier used. I'm not sure how to correct this.
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi Guest!
21422 stands for: Open treatment of palatal or maxillary fracture (LeFort I type)
And yes, there is not a need to utilize the bilateral modifier for this - you may not need a modifier at all if the procedure you're performing matched that description. You may consider modifier 51 for "multiple procedures" if applicable, or pissbly modifier 52 for reduced services if applicable, but you may also just remove the modifier when resubmitting.
Hope this helps!
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