Wiki Anatomical Modifier

[frieson.cianna@gmail.com]

Billed 28288-LT , We got denied by BCBSIL for the claim not being submitted with the appropriate anatomical modifier. We than have billed it with a corrected claim with no modifier and than again with a toe modifier and all have been denied.

Not sure why, any suggestions? We have got paid by other payers for same CPT code with the RT or LT Modifier.

 

[nickelclaw]

metatarsal head would not be a toe modifier. Make sure the laterality on dx code is the same as the modifier that was put on the CPT. I do know that some commercial insurances like TN don't take LT or RT.