# 20600, 20605, 20610 with Lt/Rt modifier



## loricpc (Mar 9, 2015)

We just went through an audit and was told we need to apply a left or right modifier on joint injection codes 20600, 20605 and 20610.  We were told CMS is "wanting" this.  Does anyone else do this and if so do you have supporting documentation from CMS? (We already use a 50 when appropriate.) If 10's pass it will be a mute point but for now what is your take?


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## Kmakar (Mar 9, 2015)

Our practice has used the -LT and -RT modifiers on unilateral injections for years.   I hope that helps.


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## mitchellde (Mar 9, 2015)

Yes you should always use the the LATERALITY modifiers for services performed only on one side of a bilateral body part or organ.  This will not go away with ICD-10 CM.  We are not replacing the modifiers with laterality diagnosis codes. We will be matching the codes to the modifiers.


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## ollielooya (Mar 9, 2015)

Yes, we bill using the anatomical modifiers.  If they are not used, MCR will deny...at least NGS will...


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## breakback (Sep 24, 2015)

I have not seen this being used, but a question has been raised as to whether we need to use RT and LT on therapeutic and/or vaccine injections. For instance, if a PT gets a pneumovax in the rt arm and a flu vax in the lt arm do we add the RT and LT modifiers to their admin codes?


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## ehanna (Sep 24, 2015)

breakback said:


> I have not seen this being used, but a question has been raised as to whether we need to use RT and LT on therapeutic and/or vaccine injections. For instance, if a PT gets a pneumovax in the rt arm and a flu vax in the lt arm do we add the RT and LT modifiers to their admin codes?





You would not use RT/LT on administration codes.


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## nrichard (Sep 25, 2015)

*Anatomic Modifiers vs Modifier50*

To commercial payers, for bilateral knee injections I bill 20610-LT, and 20610-RT-59. While I know it's not correct coding to use modifier 59 on the second line item, you will get a denial for duplicate code if you don't use it. 
For Federal payers the correct way to bill bilateral knees (and this comes from the CMS NCCI manual) is to report one line item of 20610-50 with only one unit.


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