On December 6, 2018, the DME MACs issued a joint publication advising on the proper billing of RT and LT modifiers. Effective for claims with dates of service (DOS) on or after 3/1/2019, suppliers must bill each item on two separate claim lines using the RT and LT modifiers and 1 UOS on each claim line. Do not use the combination RTLT modifier on the same claim line and bill with 2 units of service (UOS). Claim lines for HCPCS codes requiring use of the RT and LT modifiers, billed without the RT and/or LT modifiers or with the RTLT on a single claim line, will be rejected as incorrect coding.
Currently, instructions for billing products to be used bilaterally advise suppliers to use the RTLT modifier on the same claim line and indicate two (2) units of service. This instruction is being changed in the following policy articles:
- Ankle-Foot/Knee-Ankle-Foot Orthoses (AFO/KAFO)
- External Breast Prostheses (EBP)
- Eye Prostheses
- Facial Prostheses
- Knee Orthosis (KO)
- Lower Limb Prostheses (LLP)
- Orthopedic Footwear
- Refractive Lenses
- Surgical Dressings
- Therapeutic Shoes for Persons with Diabetes (TSD)
- Wheelchair Options/Accessories