Wiki Modifiers for Laterality

[jshirley10]

Our office has not been able to get a definitive answer regarding the use or discontinuation of modifiers -50, -LT, -RT, and -E1 through - E4 since the implementation of ICD10. It makes sense that with the laterality indicated in the diagnosis that using a modifier is redundant, however no one seems to be able to give us a direct answer so we are reluctant to discontinue using them. Any help would be appreciated.

 

[mitchellde]

CPT has not indicated that the modifiers will be discontinued. ICD and CPT are two different systems. Changes in one does not necessarily mean the other will change. So yes use the modifiers.

 

[CodingKing]

To add on to what mitchellde states. Diagnosis is not used to determine reimbursement, its #1 function is health statistics and #2 to determine medical necessity (except for PCS for inpatient facility). None of the payers made any changes to their systems regarding CPT as they are not related

Here is a latest from CMS on the issue (june 2015) on many of the myths that have been floating around about I10

https://www.cms.gov/medicare/coding/icd10/downloads/icd-10mythsandfacts.pdf

MYTH
When ICD-10-CM codes replace ICD-9-CM codes on October 1, 2015, it will impact how I report CPT and Healthcare Common Procedure Coding System (HCPCS) codes.

FACT
When ICD-10-CM codes replace ICD-9-CM codes on October 1, 2015, it will not impact how you report CPT and HCPCS codes, including CPT/HCPCS modifiers for physician services. While ICD-10-CM codes have expanded detail, including specification of laterality for some conditions, you should continue to follow CPT and CMS guidance when you report CPT/HCPCS modifiers for laterality.

I think everyone should read as seems a lot of people still believe some of the other things mentioned in this article. An example would be those who are using GEMS to pick the ICD-10 codes even though GEMS were not designed for this