CurrentEmpire BluecrossPolicy N/A

Modifiers LT and RT: Left Side/Right Side Procedures

Governs reimbursement and billing guidance for using LT and RT modifiers to indicate left- or right-sided procedures for Anthem Medicare Advantage claims; affects participating and non-participating professional providers and facilities for members covered under Anthem Medicare Advantage.

Policy Summary

PayerEmpire Bluecross

PolicyModifiers LT and RT: Left Side/Right Side Procedures

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateJan 1, 2015

Next Review Date

Key ActionUse industry-standard CPT/HCPCS/revenue codes and append LT or RT only to indicate left or right side; do not use LT/RT for bilateral procedure codes.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

100%reimbursement based on fee schedule or contracted rate

2modifier designators (LT, RT)

2015-01-01effective date (policy)

2017-08-14last approval / review date

LT/RT Modifier Billing Criteria

LT/RT modifier billing criteria

Covered when ALL of the following are met:

Modifiers LT and/or RT may be appended to procedure codes to indicate left or right side.

Reimbursement is based on 100 percent of the fee schedule or contracted/negotiated rate; LT/RT modifiers are informational and do not increase or decrease reimbursement.

Providers must follow authorization and medical necessity guidelines and use industry-standard, compliant CPT/HCPCS/revenue codes; services billed with LT/RT must be supported in the medical record.

Do not append LT or RT when billing for bilateral procedures or when the procedure code description includes 'bilateral' (or 'unilateral or bilateral').

Claims indicating procedures on both left and right sides are subject to multiple surgery rules.

Policy Summary

PayerEmpire Bluecross

PolicyModifiers LT and RT: Left Side/Right Side Procedures

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateJan 1, 2015

Next Review Date

Key ActionUse industry-standard CPT/HCPCS/revenue codes and append LT or RT only to indicate left or right side; do not use LT/RT for bilateral procedure codes.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Modifier Codes and Reimbursement Impact

ModifiersModifier

LT	Modifier indicating left side
RT	Modifier indicating right side

Reimbursement adjustment

Reimbursement impactModifiers LT and RT are informational and do not increase or decrease reimbursement; payment is based on 100 percent of the fee schedule or contracted/negotiated rate.

Billing useLT and RT may be appended to procedure codes to indicate the left or right side of the body when appropriate.

Bilateral proceduresDo not use LT or RT when billing for bilateral procedures or with procedure codes whose descriptor includes 'bilateral' ('unilateral or bilateral').

Multiple surgery ruleClaims showing procedures performed on both left and right sides are subject to multiple surgery rules.

Contract exceptionsReimbursement and modifier use are subject to provider, state, federal, or CMS contracts and requirements which may supersede this guidance.

Billing, Authorization, and Modifier Usage Guidance

Billing Rule

Billing and Authorization Guidance

Use industry-standard CPT, HCPCS, and revenue codes on all claim submissions. Bill services with the code that accurately describes the service, supply, or procedure performed, and ensure the medical record/office notes fully support the billed codes. Follow payer, state, federal, and CMS rules and any applicable authorization requirements; obtain prior authorization when required by the member’s benefit plan or our authorization rules. Failure to follow coding, billing, or authorization guidelines may result in claim denial, payment recovery/recoupment, or adjustment of reimbursement to reflect the appropriate services performed.

Bill using Current Procedure Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and/or appropriate revenue codes.
Modifiers LT and RT are informational when used to indicate side of body and do not change reimbursement unless other contractual rules apply.
Reimbursement is based on the applicable fee schedule or contracted/negotiated rate.
Follow prior authorization rules per the member’s plan — obtain authorization when required.

Billing Rule

Modifier Usage Constraint

Do not append Modifier LT or RT to codes that represent bilateral procedures or to procedure codes that include the word “bilateral” (or “unilateral or bilateral”) in their descriptor. LT/RT are informational modifiers only and do not convert a unilateral code into a bilateral service; services performed bilaterally are subject to multiple-procedure rules and appropriate multiple-surgery or bilateral billing conventions. Using LT/RT inappropriately may lead to claim denial or payment adjustment.

Do not use LT/RT for procedure codes described as bilateral.
Do not append LT/RT when billing bilateral procedures; follow multiple-procedure rules instead.
Claims with LT and RT indicating procedures were performed on both sides remain subject to multiple-procedure payment rules.

OpenPayer

Modifiers LT and RT: Left Side/Right Side Procedures

LT/RT Modifier Billing Criteria

Modifier Codes and Reimbursement Impact

Billing, Authorization, and Modifier Usage Guidance

Definitions and Related Policy References