Wiki LATERALITY MOD ON CENTRAL LINE PLACEMENT?

[margaret fahy]

Do you guys routinely add a laterality modifier on a central line/port, etc. placement? We never did this, and now this is being discussed. If there are insertions on both right and left sides, we would append an rt/lt, but for a single placement, we are wondering if everyone appends an rt or lt mod.

 

[Jim Pawloski]

The third party payer want the laterality modifier. So I code 36561-rt for a right sided mediport insertion.
HTH,
Jim

 

[margaret fahy]

Jim, are you saying across the board....that all third party payors want the laterality mod, or is it payor specific? I eel some payors require it and some do not....so I guess best bet would be to code the mod. Thanks so much.

 

[Tcoder4]

Jim, are you saying across the board....that all third party payors want the laterality mod, or is it payor specific? I eel some payors require it and some do not....so I guess best bet would be to code the mod. Thanks so much.

Hi, if this helps, it is a "conditional bilateral" code per the OCE (bilateral indicator of 1) - so generally laterality modifiers would be added. You can look up the code and the "bilt surg" column number helps determine if a laterality modifier is added: https://www.cms.gov/medicare/physician-fee-schedule/search?Y=0&T=4&HT=0&CT=3&H1=36561&M=5