ICD-10 Bilateral Codes

ICD-10 Bilateral Codes

Michelle Jones

10/6/2015

Good morning.

 

I wanted to thank you all for the responses and share with you a response I
received that can be found on the NGSMedicare Jurisdiction B website, in
case anybody would like it in writing:

 

Here is a clarification from Medicare:





Jurisdiction B Tip of the Week - Billing Clarification for Lateral Modifiers

We have received inquiries regarding ICD-10-CM and billing of items that
require the lateral modifiers. When submitting claims to the Jurisdiction B
Durable Medical Equipment Medicare Administrative Contractor (DME MAC) for
an item described by the same Healthcare Common Procedure Coding System
(HCPCS) code and the item is ordered for the right (RT) and left (LT) side,
you should submit one claim line with the correct HCPCS code with the RT, LT
modifiers appended and bill two units of service. If there are two ICD-10-CM
codes that specify right and left, both diagnosis codes should be submitted
on the claim.

On 9/24/2015, the Centers for Medicare & Medicaid Services (CMS) published
MLN Matters ConnectsR Provider eNews. Implementation of ICD-10-CM will not
change billing guidelines if you are providing items for the right and left
side. While ICD-10-CM codes have expanded detail, including specification of
laterality for some conditions, you will continue to follow Common Procedure
Coding (CPT) and CMS guidance in reporting CPT/HCPCS modifiers for
laterality.

Detailed information regarding coding for ICD-10-CM to report CPT/HCPCS
modifiers for laterality is included in the MLN Matters ConnectsR Provider
eNews.

 

I believe this has sufficiently answered my question.

 

Thanks again!!

 

Michelle Jones, Sr. Insurance Specialist

Progressive Prosthetic & Orthopedic Services, Inc.

380 Cleveland Place

Virginia Beach, VA 23462

                           

Phone: (757) 456-5501

Fax: (757) 671-7525

Email: <Email Address Redacted>