Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

HIPAA: HIPAA Implementation - Modifier -LT/-RT Exceptions for O & P

December 18, 2003

Effective for dates of service on or after September 22, 2003, the following Orthotic and Prosthetic (O & P) procedure codes do not require -LT (left side) and/or -RT (right side) modifiers:

L1500 – L1520
L1620
L4000
L4205
L8002
L8015
L1700
L2640
L4210
L6360
L8040
L8041
L3650
L3652
L6384
L6570
L8047
L8230
L3660
L3675
L7360 – L7368
L7900
L8310

These codes may be billed without modifiers.

Prosthetic repair and labor codes L7510 and L7520 require an -LT and/or -RT modifier unless the provider indicates in the Reserved For Local Use field (Box 19) of the claim, or as an attachment, that the repair is not for a limb prosthesis.

Also effective for dates of service on or after September 22, 2003, lift/build-up codes L3300 – L3334 may be billed with either the modifier -LT (left side) or -RT (right side). Lifts are reimbursable for one side only. Lift/build-up codes are restricted to two billing occurrences in 180 days for the same recipient by any provider.