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: