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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 (A52457External Website)
  • External Breast Prostheses (A52478External Website)
  • Eye Prostheses (A52462External Website)
  • Facial Prostheses (A52463External Website)
  • Knee Orthoses (A52465External Website)
  • Lower Limb Prostheses (A52496External Website)
  • Orthopedic Footwear (A52481External Website)
  • Refractive Lenses (A52499External Website)
  • Surgical Dressings (A54563External Website)
  • Therapeutic Shoes for Persons with Diabetes (A52501External Website)
  • Standard Documentation Requirements Policy Article (A55426External Website)

Publication History

January 26, 2023 Originally Published
November 3, 2023 Removed Wheelchair Options/Accessories Policy Article (A52504External Website) due to revised coding guidelines for these items. See: Policy Article Revisions Summary for October 26, 2023

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