November 3, 2023
Correct Coding Reminder – RT and LT Modifiers - Revised
Several DME MAC LCD-related Policy Articles require the use of the right (RT) and left (LT) modifiers for certain HCPCS codes. Suppliers must use the RT and LT modifiers when billing two of same item or accessory on the same date of service when the items are being used bilaterally.
Suppliers must bill each item on two separate claim lines using the RT and LT modifiers and 1 unit of service (UOS) on each claim line. Do not use the combination RTLT modifier on the same claim line and bill with 2 UOS.
Claim lines for HCPCS codes requiring use of the RT and LT modifiers, billed without the RT and/or LT modifiers or with the RTLT on a single claim line, will be rejected as incorrect coding.
Refer to the following resources for additional coding and documentation requirements:
- Ankle-Foot/Knee-Ankle-Foot Orthoses (A52457)
- External Breast Prostheses (A52478)
- Eye Prostheses (A52462)
- Facial Prostheses (A52463)
- Knee Orthoses (A52465)
- Lower Limb Prostheses (A52496)
- Orthopedic Footwear (A52481)
- Refractive Lenses (A52499)
- Surgical Dressings (A54563)
- Therapeutic Shoes for Persons with Diabetes (A52501)
- Standard Documentation Requirements Policy Article (A55426)
Publication History
January 26, 2023 | Originally Published |
November 3, 2023 | Removed Wheelchair Options/Accessories Policy Article (A52504) due to revised coding guidelines for these items. See: Policy Article Revisions Summary for October 26, 2023 |