RT and LT Modifier Requirements for Intravitreal (Eye)
and Intra-Articular (Knee) Injections
and Intra-Articular (Knee) Injections
Each submitted claim must reflect the anatomical site, right (RT) or left (LT), where the injection was administered. This modifier requirement is applicable when a patient receives a unilateral injection (one side), or bilateral injections (both sides) during a single visit. Bilateral injections on a single visit are to be billed in two (2) separate claims using RT and LT
modifiers.
Procedure Code
|
Drug name
|
C9257
| INJECTION, BEVACIZUMAB, 0.25 MG (ATVASIN) |
J2503
| INJECTION, PEGAPTANIB SODIUM, 0.3 MG (MACUGEN) |
J2778
| INJECTION, RANIBIZUMAB, 0.1 MG (LUCENTIS) |
J7310
| GANCICLOVIR, 4.5 MG, LONG-ACTING IMPLANT (VITRASERT) |
J7311
| FLUOCINOLONE ACETONIDE, INTRAVITREAL IMPLANT (RETISERT) |
J7312
| INJECTION, DEXAMETHASONE, INTRAVITREAL IMPLANT, 0.1 MG (OZURDEX) |
J7321
| HYALURONAN OR DERIVATIVE, HYALGAN OR SUPARTZ, FOR INTRA-ARTICULAR INJECTION, PER DOSE |
J7323
| HYALURONAN OR DERIVATIVE, EUFLEXXA, FOR INTRA-ARTICULAR INJECTION, PER DOSE |
J7324
| HYALURONAN OR DERIVATIVE, ORTHOVISC, FOR INTRA-ARTICULAR INJECTION, PER DOSE |
J7325
| HYALURONAN OR DERIVATIVE, SYNVISC OR SYNVISC-ONE, FOR INTRA-ARTICULAR, INJECTION, 1MG |
J7326
| HYALURONAN OR DERIVATIVE, GEL-ONE, FOR INTRA-ARTICULAR INJECTION, PER DOSE** |
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