Orthopedic Coding Alert

Question: I’ve been coding for about a year, and I’m getting better. One aspect that still confuses me is the anatomical modifiers. I’m not really sure when or how to use them. Could you help?

Wisconsin Subscriber

Answer: “Anatomical modifiers designate the area or part of the body on which the procedure is performed and assist in prompt, accurate adjudication of claims,” explains Mary I. Falbo, MBA, CPC, CEO of Millennium Healthcare Consulting Inc. in Lansdale, Pennsylvania.

“They are appended to coronary artery, eyelid, finger, side of body, and toe. you should only apply anatomical modifiers to procedure or supply codes, Falbo reminds. “They should not be attached to E/M [evaluation and management] services, even if the chief complaint is specific to one side. These modifiers also should never be attached to a diagnosis code.”

Since you are working in an orthopedic office, you can leave the eyelid and coronary artery modifiers off your checklist and focus on these:

• Use modifiers F1 (Left hand, second digit) through FA (Left hand, thumb) for fingers.
• Use modifiers RT (Right side) and LT (Left side) to indicate a procedure’s laterality. Some payers require these modifiers and some don’t, so you’ll need to check each payer’s rules on this one.
• Use modifiers T1 (Left foot, second digit) through TA (Left foot, great toe) for toes.