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Hi, Barbie,

Unilateral procedures such as the diagnostic Unilateral Mammos don't need a modifier. The CPT code makes the distinction that the procedure is Unilateral. Therefore, no modifier is really necessary.

If the procedure is a bilateral procedure and you only do 1, then you'd use a -52 modifier to tell the insurance company that you actually did less work than the CPT originally intended. Off the top of my head, I can't really think of a procedure like this, but I'm sure it exists.

Bilateral procedures do need a modifier and -RT and -LT work the best, from what I'm seeing.

When you are doing a radiological procedure such as an MRI or CT of the right knee and then of the left knee, it's important to use the -RT and the -LT or the insurance company will consider the second CPT a duplicate charge.

Some carriers want the -50 modifier, some want the -RT/-LT.

I wish I could tell you that there's a guide about who wants what in terms of these particular modifiers, but there really isn't anything available like that because it's carrier specific, not industry-specific.

The key is in the CPT description: If the wording of the CPT states that it's a unilateral procedure and you only do one side, no modifier.

If the wording states a unilateral procedure (like an Xray or CT or MRI) and you do 2 sides, use the modifiers.

Hope this helps.