Podiatry Coding & Billing Alert

Answer: The best coding option is modifier LT (Left side) rather than modifier TA (Left foot, great toe), although keep in mind you have not specified the foot on which the procedure is planned. According to the information given by you, the indication is that the procedure is on the left foot. It should definitely be coded as LT for the procedure. If you code the toe, which may be more specific, it will be rejected since the procedure took place on the foot and not on the toe.All bunion or hallux valgus procedures include the metatarsal.

 

HCPCS Level II modifiers LT and RT (Right side) are the better choices to identify the left and right sides of the body when the procedure is performed on one side of the body and the procedure location has a parallel organ on the other side of the body. Therefore, the modifiers LT and RT are more appropriate if, for example, the patient had a lesion removed from the left foot, and there was a lesion biopsied on the right foot. Your procedure falls under this very category as the bunion is not on the toe, rather on the foot itself with the involvement of the metatarsal.

 

However, if the procedure would have been on the toe itself, then there are other Level II anatomical modifiers available to identify and describe exact body parts, and those modifiers should be used instead. Such modifiers are definitely available for toes, eyes, and fingers. For instance, modifiers TA to T9 are available for specific procedures performed on the phalanges of the foot. As the bunionectomy procedure 28299 (Correction, hallux valgus (bunion), with or without sesamoidectomy; by double osteotomy) is performed on the side of the big toe, the choice is between LT and RT for the procedure. As you have indicated, the bunion is on the left toe, so you should code the procedure with modifier LT.