Bilateral Savi - Radiation Oncology

I have a patient that is RT & LT Stage 1 Beast Cancer and is going to be treated bilateral APBI. When we bill for APBI I apply the modifier 76 to the second charge in the afternoon (6 hours from the morning treatment).

My question is, that we are treating the patient APBI and she is bilateral as well? can I add the modifier 50 to the second charge as well with the modifier 76? OR am I able to bill a total of 4 charges in one day since we are treating both breast in the morning and then again in the afternoon. Please see the below examples

Example 1:

Morning: 77786

Afternoon: 77786 Mod 50; 76

Example 2:

Morning: 77786 & 77786 Mod 50; 76

Afternoon: 77786 & 77786 Mod 50; 76

Since we are a Freestanding Clinic, should I add on the RT & LT Modifiers to the billing as well?

Thank you,

Shannon

Bilateral Savi - Radiation Oncology