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October 31, 2024

Finger, Hand, Hand-Finger, Wrist-Hand, Wrist-Hand-Finger Orthoses Modifiers

CGS receives questions on the modifiers to bill with Finger, Hand, Hand-Finger, Wrist-Hand, Wrist-Hand-Finger, and Wrist-Hand-Finger Dynamic Flexor Hinge orthoses.

ORTHOSES TYPES HCPCS
Finger L3925, L3927, L3933, and L3935
Hand L3917 and L3919
Hand-Finger L3912, L3913, L3921, L3923, L3924, L3929, and L3930
Wrist-Hand L3905, L3906, L3908, L3915, and L3916
Wrist-Hand-Finger L3806-L3809, and L3931
Wrist-Hand-Finger Dynamic Flexor Hinge L3900 and L3901

You must use the left (LT) and right (RT) modifiers with orthosis base codes, additions, and replacement parts.

When you bill the same code on the same date of service:

  • Bill each item on separate claim lines using the LT or RT modifiers
  • Bill 1 unit of service on each claim line.
  • Don't bill more than one item on the same claim line.

We will reject for incorrect coding:

  • Claims missing the LT or RT modifier
  • Claims billed with LTRT on the same claim line and 2 units of service

Use the Advanced Modifier Engine (AME) to help bill the correct modifier.

References and Resources:

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