During the first 6 months into the transition to reporting International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), physicians and coders have had some struggles with the new code set. The following questions and answers are provided in response to some of the more frequently noted and complex concerns:

Is it still necessary to append modifiers to procedure codes indicating laterality? Or is this now unnecessary because ICD-10-CM codes indicate laterality?

Yes, procedure modifiers are still necessary. Although ICD-10-CM codes do specify laterality, most adjudication systems will require the use of Current Procedural Terminology (CPT®) or Healthcare Common Procedure Coding System (HCPCS) modifiers for correct claim processing. Claim edits configured to allow the same procedure performed on 2 different anatomic sites (eg, bilaterally) are typically based on procedure codes and related CPT or HCPCS modifiers and are not affected by diagnosis codes reported. Failure...

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