Change to RT and LT Modifier Use
- By Brad Ericson
- In Billing
- May 31, 2019
- Comments Off on Change to RT and LT Modifier Use
The Durable Medical Equipment Medicare Administrative Contractors (DME MAC) are changing the requirement that medical coders to use the right (RT) and left (LT) modifiers for certain HCPCS codes, and that the modifiers be used when billing two of the same item or accessory on the same date of service and the items are being used bilaterally.
The DME MACs currently instruct suppliers to use modifier RTLT on the same claim line and indicate two units of service, but all that is changing for Ankle-Foot/Knee-Ankle-Foot Orthoses (AFO/KAFO), External Breast Prosthesis (EBP), Eye Prosthesis, Knee orthoses (KO), Lower LImb Prostheses (LLP), Orthopedic Footwear, Refractive Lenses, Surgical Dressing, Therapeutic Shoes for Persons with Diabetes (TSSD), and wheelchair options/accessories policy articles.
Use Two Lines
Since March 1, suppliers must bill each item on two separate claim lines using the RT and LT modifiers and 1 unit of service on each claim line. Avoid using the combination on the same claim line and bill with 2 units of service. Claim lines for HCPCS codes requiring use of the RT and LT modifiers, billed without the RT or LT modifiers or with the RTLT on a single line simply will be rejected.
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800-626-2633
Does a modifier need to be used for “proof of delivery”? If so, what?
Your article is very confusing. I have read it three times, and am still not sure of the correct way to bill for these services. Stop telling us what they do not want on the claim lines. Tell us what they do want on the claim, and how they want it.