RT LT Modifier Use

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The DME MACs issued instructions on December 6, 2018 “Correct Coding – RT and LT Modifier Usage Change”.

Right (RT) and left (LT) modifiers for bilateral claims should now be billed on separate claim lines. This is applicable when two of the same items (same HCPCS codes) are provided on the same date of service (DOS). Effective 3/1/19.

Bilateral items not billed on separate claim lines will be returned as unprocessable. 

As of August, 12.6% of Jurisdiction C claims that included RT and LT modifiers would have been rejected.

-CGS Administrators

Claims returned as non processable must be resubmitted. They do not have appeal rights and cannot be reopened or submitted for adjustment.