Wiki L3000 Bilateral

[suemt]

What is the correct modifier to use for L3000 when done for both right and left?

This is how it was submitted:
L3000 NU LT (was paid)
L3000 NU RT 59 (denied by insurance as inappropriate modifier)

Thanks for any feedback!

Sue

 

[britbrit852003]

We use this code quite frequently and we just bill it with 2 units. So its one charge line with 2 units.

 

[suemt]

Thanks, Brittany! We'll see if that works.

 

[MarciaH]

We bill for L3000 on two lines:
L3000 RT
L3000 LT
No other modifiers and have been paid for both.

 

[suemt]

Interesting. So are there really two ways to reflect this (you say tomAto, I say tomato)? Or does it vary by payor?

 

[nswanson2]

In my experience it varies by payor. Currently BCBS-Michigan is only paying for one orthotic (as opposed to two) if L3000 is billed on one line with a quantity of two, and a KX, RT, LT modifier combo. The way we now bill it is on 2 separate lines.

L3000 KX RT
L3000 KX LT

 

[debflutter]

We bill it on two separate lines with a -RT and a -LT and have gotten paid