tci Outpatient Facility Coding Alert - 2014 Issue 11

Reader Question: Familiarize Yourself With the 4 DME Modifiers

Question: What other modifier do I use with RT or LT when I bill for DME equipment?  Rhode Island Subscriber Answer: There are four important modifiers that you may append to DME claims as appropriate: Modifier KX (Requirements specified in the medical policy have been met) – Reporting the KX modifier identifies that the provider met the requirements identified in the medical policy. Documentation is essential to support that the item is reasonable and necessary and that the specific coverage criteria specified in each policy have been met. The KX modifier has differing usage requirements depending on the...

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