Reader Question: Achilles Tendon

Question: With 27650 (repair, primary, open or percutaneous, ruptured Achilles tendon) is it correct to use an -RT (right) or -LT (left) modifier with this code, or does it not need a modifier at all?

California Subscriber

Answer: Yes, you would use -LT and -RT on any paired organs (arms, legs, lungs, etc.). If another modifier is needed, say modifier -59 (distinct procedural service), you should always use the most specific modifier first. And, if you use more than one level-two modifier (in the rare occurrence both feet were affected) youd have to repeat the HCPCS code on another line of the UB-92 claim form and then add the other appropriate -RT and -LT modifiers.

There can only be one anatomical site modifier per procedure code, per line on the claim form.

It is also important to remember that not all codes require modifiers to show the anatomical site. On some occasions, the definition of the code already indicates the location of the injury. For example, 28496 (percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation) already identifies the anatomical site as the great toe.

- Published on 2001-04-01