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October 8, 2019

RT LT Modifier Billing Changes

The DME MACs issued a "Correct Coding - RT and LT Modifier Usage Change" joint publication on December 6, 2018, which provided instructions for billing right (RT) and left (LT) modifiers on separate claim lines. This is applicable when two of the same items or accessories (same HCPCS codes) are provided on the same date of service (DOS) and the items are being used bilaterally and was effective for DOS on or after 3/1/19. Applicable Policy Articles have been updated to include these instructions.

Effective for claims received on and after 10/15/2019, bilateral items not billed on separate claim lines will be returned as unprocessable. Claims returned as unprocessable must be resubmitted. Unprocessable claims do not have appeal rights and cannot be reopened or submitted for adjustment.

Click here for the full list of HCPCS codes requiring RT and LT modifiers and impacted by the updated Policy Articles.

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