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Linda Collins Blogger

Avoid Non Processable Bilateral Claims

Posted by Linda Collins | June 05, 2019

The DME MACs issued a joint publication notifying suppliers of a change in the way to bill for bilateral products dispensed on the same day. Traditionally, when two of the same items are given to patients for use on both limbs, the claim is billed with the RTLT modifier and 2 units of service.

Effective for claims with dates of service on or after March 1, 2019, suppliers must bill bilateral products on two separate claim lines. One line will have the HCPCS code with the RT modifier and the next claim line will have the same HCPCS code with the LT modifier. Each unit of service is one.

Claims with bilateral items billed on the same line will be denied as  non-processable. These claims have no appeal rights. This means you cannot resubmit or appeal payment on the claim.

Bilateral claims must be billed with the right (RT) and left (LT) items on separate lines.

More information can be found here

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