Medicare AdvantageDocumentationMedium impact
Policy Reminder: Healthfirst Anatomical Modifier Requirement for Surgical Procedures
Healthfirst·Orthopedics, General Surgery, Cardiothoracic Surgery +9 more·Coding
We identified it
Jun 20, 2026
Summary
Healthfirst is reminding providers that anatomical modifiers must be submitted with all surgical procedures that can be performed at multiple anatomical sites. This is a reinforcement of existing AMA CPT Manual requirements, not a new policy change.
Action Required
Immediately: Billing team must verify that anatomical modifiers (such as -LT, -RT, -E1-E4, -F1-F9, -T1-T9) are being appended to all applicable surgical CPT codes when procedures are performed at specific anatomical sites. Review current billing practices to ensure compliance with Healthfirst requirements and update billing system edits if needed to prevent claim denials.