The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) issued a joint publication about changes to billing for bilateral products that are delivered on the same day. Effective for claims with dates of service on or after March 1, 2019, suppliers must bill each item on two separate claim lines using the RT and LT modifiers and one unit of service on each claim line. The instruction is being changed for AFOs/KAFOs, KOs, lower-limb prostheses, orthopedic footwear, and therapeutic shoes for people with diabetes.
Current instructions for billing bilateral products instruct suppliers to use the RTLT modifier on the same claim line and indicate two units of service. After February 28, 2019, claim lines for Healthcare Common Procedure Coding Systems (HCPCS) codes that require RT and LT modifiers but are billed without the modifiers or with the RTLT on a single claim line will be rejected as incorrect coding.
For more information, refer to the following policy articles:
AFOs/KAFOs (A-52457), KOs (A-52465), lower-limb prostheses (A-52496), orthopedic footwear (A-52481), and therapeutic shoes for persons with diabetes (A-52501).
