# Two Modifiers, Which goes first



## Candice_Fenildo (Dec 21, 2013)

Hi all. I am reaching out to all the fabulous coders on here. If I must use an AS modifier and a LT modifier, which one is listed first on the HCFA 1500? 

 I know that the modifier that affects reimbursement is listed first but I would think that both of these modifiers are reimbursement modifiers? 

 Would love some feedback : )

 Thanks!!


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## OCD_coder (Dec 22, 2013)

The AS modifier effects the reimbursement as it is paid at a reduced rate, so will be listed first.  

The LT and RT is classified as a Level 1 HCPCS Statistical/Informational modifier and would be listed 2nd.  The modifier in and of itself does not effect the percentage or how it reimburses.  If you happen to bill with an LT and RT the multiple procedure rule applies and it is perceived that they are financial, but in reality they are still just informational.

CMS list of Statistical/Informational Modifier, effective 2014;

http://www.cms.gov/Medicare/Coding/...S.html?DLPage=1&DLSort=0&DLSortDir=descending


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## Candice_Fenildo (Dec 22, 2013)

Thanks so much OCD_Coder!!  I have auditing until I was blind this weekend and I knew that but I needed to also hear it from someone else  

I am glad that it was you! you are a wealth of knowledge as well! 


Merry Christmas


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## Kiran19791979 (Dec 27, 2013)

*AS and LT/RT modifiers*

I do agree with the answer given by OCD_Coder.

Rationale: 

1. AS specifies about the assistance of the professional service renderred and needs to be prioritized.

2. LT/RT are side indicators and can be moved to secondary position.

Hope this helps!
Merry Christmas!!!
Happy New Year in advance!!!


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