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Ask a Rev Cycle Expert: Laterality Modifiers and CPT® Code 63047?

Question:

Why would modifiers LT Left Side or RT Right Side be used on a claim when the payment indicator for bilateral is 2? An example is Current Procedural Terminology (CPT®) code 63047 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar.

Answer:

Some CPT® codes represent a unilateral or a bilateral procedure based on the description. As such, modifier 50 Bilateral Procedure would not be appropriate, but modifiers RT and LT could be used to indicate which side of the body the procedure is performed on when performed unilaterally. Some payers may wish to have this information provided to them and some facilities may wish to track this information internally. Additionally, it’s important to remember that the bilateral indicator applies to physician reimbursement and does not necessarily correspond to appropriate coding for facilities.

Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).