The coding guidance that exists when dispensing bilateral DME items is changing effective March 1, 2019. This change applies to ankle-foot orthoses, knee-ankle-foot orthoses, lower limb prostheses, surgical dressings, orthopedic footwear, and therapeutic shoes for persons with diabetes.
Currently, when dispensing two or more of these same items on the same date of service and the items are to be used bilaterally, the instruction from the DME MACs is to list the item once on one claim line with a “RTLT” modifier and to indicate the total number of units dispensed. This protocol is changing, effective March 1, 2019. As of that date, correct coding for this scenario will call for listing each item on two separate claim lines, with a “RT” modifier on one and a “LT” modifier on the other, along with the corresponding number of units dispensed of each. After March 1, 2019, any claim submitted with a “RTLT” modifier will be rejected.
Reference:
Joint DME MAC article, “Correct Coding - RT and LT Modifier Usage Change”
https://med.noridianmedicare.com/web/jadme/policies/dmd-articles/2018/correct-coding-rt-and-lt-modifier-usage-change