1 / 4

Know your DME Modifiers

Are you struggling to deal with your DME Modifiers Billing chaos? Contact our experts at MBC Medical Billing Services at 1888-357-3226.<br><br>Click here for more information: https://bit.ly/3YzuCLb

alicecarlosmbc
Download Presentation

Know your DME Modifiers

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Visit our website: Click here Follow us: Know your DME Modifiers Equipment that provides therapeutic benefits to a patient and is primarily for long-term and home use is termed DME. Due to a wide variety of models for DME, the Centers for Medicare and Medicaid Services (CMS) instituted the Healthcare Common Procedure Coding System (HCPCS) and modifiers that correspond to the parameters policy and LCD and make the HCPCS code valid before claim processing. Here we shared the DME Modifiers which are divided into several categories: DME Modifiers are divided into several categories: Routinely purchased Pricing Modifiers: NU Purchase of New DME RR Rented DME UE Purchase of Used DME NR New when rented Capped Rental Items and modifiers: One can use RR in this category except for wheelchairs where the patient is allowed the option to buy one. Others are: BR The receiver has elected to rent BP The receiver has elected to purchase Copyright © Medical Billers and Coders. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 1

  2. Visit our website: Click here Follow us: BU Rent or purchase not selected past 30 days despite a notification KH Purchase or First rental month KI Second and third rental months KJ Fourth to thirteenth rental months KR Rental but partial month billing LL Lease/Rental (Medicaid) Other Categories: MS Maintenance DME MM Maintenance and Servicing RP Replacement and repair A1 to A9 Surgical Dressings CG Spinal Orthosis DME Modifiers for Oxygen and the Corresponding equipment: RR Rental QE Prescribed oxygen is less than 1 LPM QF Prescribed oxygen exceeds 4 LPM and portable oxygen is prescribed QG Prescribed oxygen is greater than 4 LPM QH When an oxygen-conserving device is used with an oxygen delivery system Functional DME Modifiers for Prosthetics and Orthotics: K0 to K4 Used for various categories in Lower Limb Prostheses RA Replacement of DME, orthotic or prosthetic QF Replacement of a part of the above Copyright © Medical Billers and Coders. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 2

  3. Visit our website: Click here Follow us: Osteogenesis Stimulators: KF modifier (FDA Class III device) to be used with E0747, E0748, and E0760. Tape (A4450, A4452): AX Items in concurrence with dialysis services AU Items in urological, ostomy, or tracheostomy supply AV Items with a prosthetic or orthotic device AW Items in surgical dressing with billing codes for tape A4450 and A4452 Drug Formulations (pedorthics.org): KO Single drug unit dose formulation KP The first drug of a multiple-drug unit dose formulation KQ Second or subsequent drug of a multiple drug unit dose formulation Anatomic DME Modifiers: RT and LT (Left) (Right) modifiers are used in cases such as refractive lenses, eye prostheses, facial prostheses, orthopedic footwear, etc. KM Replacement of facial prosthesis including new impression KN Replacement of facial prosthesis using previous master model Used in cases such as external infusion pumps, home dialysis supplies, nebulizers, hospital beds, walkers, cervical traction devices, etc. KX KS The patient is glucose monitor supplied, not insulin Up-gradation/Prescription requirement: EY Used when a supplier does not have a doctor’s order. Copyright © Medical Billers and Coders. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 3

  4. Visit our website: Click here Follow us: GA When a supplier has an ABN on file. GZ Item denied as not reasonable. GY When an item is not covered and does not have a Medicare benefit. modifiers are upgrades wherein GK is a necessary upgrade of the equipment whereas GL is not. GK and GL Added modifiers: KB or 99 used in cases of 4 or more modifiers. KL (delivered by mail), KV, KT, J4, KE, KG, KK, KU, KW, KY Refers to DMEPOS items and their bidding. As mentioned above, DME modifiers are two-character alpha or numeric codes that are added to the end of HCPCS codes to elucidate the benefits when billed. Adding these augments the reimbursement process. Medical Billers and Coders (MBC) is a leading medical billing company providing complete medical billing services. Our certified coders follow accurate DME billing and coding guidelines to ensure an accurate selection of procedure codes along with modifiers. To know more about our DME billing and coding services, contact us directly at 888-357-3226. Copyright © Medical Billers and Coders. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 4

More Related