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Multiple modifiers 59, rt, lt

  1. Default Multiple modifiers 59, rt, lt
    Medical Coding Books
    We recently billed:
    20610-RT
    20610-LT
    J7325-RT 48 units
    J7325-LT 48 units
    J1020-59
    J1020-59
    The carrier only paid the 20610 codes.
    The carrier denial says invalid modifier. I think that the Rt and LT should not be used for a J-code, but I don't know how to properly bill this Synvisc.

  2. Default
    I don't submit with RT/LT w J codes.

  3. Default
    We don't use RT/LT modifiers on J-codes either.

    ~L
    CPC, CGSC, COSC

  4. #4
    Location
    Sioux Falls South Dakota
    Posts
    358
    Default
    You also would not need the modifier 59 on your J codes, just bill the units on the medications.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

  5. #5
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    For Medicare, Blue's, UHC we bill bilateral synvisc injections:
    20610-50x1 at 150% of the fee
    J7325 x96
    All others:
    20610
    20610-50
    J7325 x96

    No problems whatsoever.
    Lisa Bledsoe, CPC, CPMA

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