Fee Navigator

    Modifier: LMTS

    LIMITS

    This modifier is used to override restrictions for a service/procedure.

    Codes:

    Code:Description:
    DSCH
    DISCHARGED
    Explicit

    As stated in GR 5.1.4, indicates payment for a patient who was discharged from an emergency department, AACC or UCC and returned the same day.

    LWDT
    COMPLETE LOWER DENTURE
    Explicit

    Indicates the oral examination is for a complete lower denture.

    LWPT
    PARTIAL LOWER DENTURE
    Explicit

    Indicates the oral examination is for a partial lower denture.

    LWRL
    PARTIAL OR COMPLETE LOWER RELINE
    Explicit

    Indicates the oral examination is for a reline of a partial or complete lower denture.

    L40
    UNDER 40 WEEKS CONCEPTUAL AGE, ROLE OF SURGEON
    Explicit

    Infants under 40 weeks of conceptual age. Applies only to specific general surgery procedures.

    L40ANE
    UNDER 40 WEEKS CONCEPTUAL AGE, ROLE OF ANESTHETIST
    Explicit

    Infants under 40 weeks of conceptual age. Applies only to specific anesthetic services. May also be claimed in addition to the time based anesthetic modifiers (ANEST/2ANES).

    L44
    UNDER 44 WEEKS CONCEPTUAL AGE, ROLE OF SURGEON
    Explicit

    Infants under 44 weeks of conceptual age. Applies only to cardiovascular and thoracic surgery.

    L44ANE
    UNDER 44 WEEKS CONCEPTUAL AGE, ROLE OF ANESTHETIST
    Explicit

    Infants under 44 weeks of conceptual age. Applies only to specific anesthetic services. May also be claimed in addition to the time based anesthetic modifiers (ANEST/2ANES).

    NEWCON
    NEW CONDITION FOR OPTOMETRY
    Explicit

    Indicates an Optometrist is providing optometric services to an eligible resident for a new condition whose diagnostic code contains the same first three-digit root as a condition previously billed in the same benefit year.

    NEWEP
    NEW EPISODE FOR OPTOMETRY
    Explicit

    Indicates an Optometrist is providing optometric services to an eligible resident for a condition that was previously billed, but the resident incurred a new occurrence of the condition in the same benefit year.

    OPHTCO
    OPHTHALMOLOGY CO-MANAGEMENT
    Explicit

    used to identify ongoing co-management of eye care for an eligible resident between an Optometrist and an Ophthalmologist

    SPCDRG
    SPECIFIED DRUGS FOR OPTOMETRY
    Explicit

    Indicates an Optometrist is providing optometric services as the patient is receiving treatment with the drug Chloroquine (Aralen), Ethambutol (Myambutol and Servambutol), Hydroxychloroquine Sulfate (Plaquenil), or Tamoxifen (Novaldex).

    TOC
    TRANSFER OF CARE
    Explicit

    Indicates the care of a hospitalized patient was transferred to a second physician in the same facility. The physician receiving the transferred patient must use TOC.

    UPDT
    COMPLETE UPPER DENTURE
    Explicit

    Indicates the oral examination is for a complete upper denture.

    UPPT
    PARTIAL UPPER DENTURE
    Explicit

    Indicates the oral examination is for a partial upper denture.

    UPRL
    PARTIAL OR COMPLETE UPPER RELINE
    Explicit

    Indicates the oral examination is for a reline of a partial or complete upper denture.