HCPCS Modifier LC

Published 07/16/2020

Description
HCPCS Modifier LC is used to report the left circumflex coronary artery.

Guidelines and Instructions
This modifier may be submitted with the following CPT codes:
  • 92973
  • 92978–92979 
  • 92980–92982
  • 92984
  • 92995–92996  
  • 93571–93572
  • 92920–92944  
If you are submitting this HCPCS modifier and the associated procedure code is subject to Correct Coding Initiative (CCI) editing, no additional modifier is needed to note an exception to the CCI edit.
  • Under certain circumstances, the physician may need to indicate that a procedure or service was distinct or independent from other services performed on the same day. HCPCS modifier LC is used to identify situations in which it is appropriate to submit these specific CPT codes for separate reimbursement.
  • Before submitting this modifier, it is important to verify whether the services are bundled through CCI. CCI edits may be updated as often as quarterly. Access the CMS website for the National Correct Coding Initiative.
  • Code pairs identified with indicator 0 in the CCI list cannot be submitted separately for reimbursement under any circumstances. There are no exceptions to the CCI edits for indicator 0 codes.
  • Code pairs identified with indicator 1 may be submitted separately for reimbursement if the two services are performed in a different session or patient encounter, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same physician. Documentation must be maintained in the medical record to support the use of this modifier. No special documentation is required with the claim when HCPCS modifier LC is submitted.
  • Code pairs identified with indicator 9 are not subject to CCI edits. No modifier is required in these situations.

Was this article helpful?