decisionhealth Newsletters, Coder Pink Sheets - 2022 Issue 7 (July)
Mind your modifiers: Consider payer preferences when debating modifiers LT/RT and 50
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Article Overview
This brief coding Q&A explains the general use of bilateral and laterality modifiers and notes that payer policies may influence how a service is reported. It also touches on situations where an additional distinct-service modifier may be considered and references NCCI-related guidance for coders and billers working with CPT reporting.
Why This Topic Matters
Laterality and bilateral reporting can vary by payer, so coders need to understand when a claim may be accepted in more than one format. The topic matters for accurate claim submission, compliance, and consistent reporting of services involving one side or both sides of the body.
What You Will Learn
- How laterality and bilateral reporting are discussed in general coding guidance
- Why payer preferences can affect claim formatting
- When distinct-service considerations may arise alongside body-side modifiers
- What type of documentation review is emphasized for modifier selection
Who Should Read This
- Medical coders
- Coding auditors
- Billing staff
- Practice managers
- Revenue cycle professionals
Modifiers Discussed
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