Respiratory Assist Devices (RAD) E0470 and E0471 - Billing Reminders

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
March 28th, 2017

Add the KX modifier to all claims for RADs and accessories for the first through third months if all the
coverage criteria have been met.

Add the KX modifier to all claims for the fourth month and thereafter if all the coverage criteria have been met and if the physician signed and dated a statement declaring that the beneficiary is compliantly using and is benefiting from the device.

The signed physician statement must be obtained and kept on file by the supplier for continued coverage beyond three months.

The signed physician statement should not be sent in with the claim but must be available upon request.

When there is an expectation of a medical necessity denial, the GA modifier must be added to the code. These cases apply if a valid Advance Beneficiary Notice (ABN) or GZ modifier has been obtained or if a valid ABN has not been obtained.

Claims for ventilators (E0465E0466) used for the treatment of conditions described in the RAD LCD will be denied as not reasonable and necessary. 


Respiratory Assist Devices (RAD) E0470 and E0471 - Billing Reminders. (2017, March 28). Find-A-Code Articles. Retrieved from

© InnoviHealth Systems Inc

Article Tags  (click on a tag to see related articles)

Publish this Article on your Website, Blog or Newsletter

This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active. If you would like to publish this article, please contact us and let us know where you will be publishing it. The easiest way to get the text of the article is to highlight and copy. Or use your browser's "View Source" option to capture the HTML formatted code.

If you would like a specific article written on a medical coding and billing topic, please Contact Us.


innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (8-5 Mountain)
free demo
request yours today
free subscription
for any budget

Thank you for choosing Find-A-Code, please Sign In to remove ads.