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.

