0699T — Njx pst chmbr eye medication
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- Claims must report the appropriate laterality modifier (-RT or -LT) on each claim line for unilateral procedures or the appropriate bilateral modifier for bilateral procedures; documentation on the claim itself (modifier placement) is required to avoid denial.
- The policy does not specify additional medical record forms or certifications; compliance is determined by correct coding/modifier reporting on the claim.
Key Coverage Criteria
- Claims for CPT/HCPCS codes describing services on anatomic structures that can be distinguished as left or right must include the appropriate laterality modifier (-RT or -LT) on each claim line for unilateral procedures.
- Bilateral procedures must be indicated by the appropriate bilateral modifier (use the payer- or code-specific bilateral modifier rather than -RT/-LT).
- CPT codes whose descriptions explicitly state 'unilateral or bilateral' do not require additional laterality modifiers.
1 Active Policy
A56869 — Billing and Coding: Use of Laterality Modifiers
Related Codes
Have a follow-up question?
Ask Verity about documentation requirements, denial risks, or coverage in your state.