|Modifier -50, Bilateral Procedure
You will append modifier 50 for procedures that are obviously billable as bilateral (or two sides,
both sides), performed on the same day, the same operative session, on identical anatomical
sites, organs (arms, legs, spine).
A Facet Nerve Block Injection (CPT Code 64493 Injection(s), diagnostic or therapeutic agent,
paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance
(fluoroscopy or CT), lumbar or sacral; single level) --- is unilateral and can be billed as bilateral.
When using a modifier 50, make sure you only bill for one unit on the claim form since there is only
1 procedure performed bilaterally.
Though guidelines from other payers may differ. They may require you to list it twice (line 1 and line
2 on the claim form). You are responsible to clarify this with your payors.
You use this modifier with add-on codes too! Do not use this modifier with procedures which are
already described as bilateral procedures.
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AMA (American Medical Association).
*** Always consult your CPT Code Book! and the NCCI Edits
*** Get more information on clinical guidelines and policies from your local CMS carriers and from
your third party payors
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