| NHIC, Corp.DME MAC A ListServe | For Immediate Release |
July 30, 2009
Billing Reminder - Reopening Rejected Claims for Missing KX ModifiersRequesting a reopening to correct a claim that is missing one of these modifiers will no longer be an available option.Effective for dates of service beginning August 1, 2009, the LCD for Therapeutic Shoes for Persons with Diabetes has revised instructions concerning the use of the KX and GY modifiers.Recently use of the GA, GY and GZ modifiers has been added to some policies to indicate that the relevant KX modifier requirements have not been met. Failure to use these modifiers correctly will result in a rejection.These changes will be effective for dates of service beginning September 1, 2009 for the following LCDs:Automatic External DefibrillatorsCervical Traction DevicesCommodesEpoetinHome Dialysis Supplies and EquipmentPositive Airway Pressure DevicesRespiratory Assist DevicesThese changes will be effective for dates of service beginning October 1, 2009 for the following LCDs:High Frequency Chest Wall Oscillating (HFCWO) DevicesHospital Beds and AccessoriesManual Wheelchair BasesNegative Pressure Wound Therapy (NPWT)Orthopedic FootwearPower Mobility DevicesRefractive LensesOther policies will add these modifiers over the coming months.Most claims denials occur as a result of a few common reasons. One of the most common is failure to add the KX modifier to a HCPCS code indicating that requirements specified in the medical policy have been met. In the past, these denials were often corrected either with a reopening or a redetermination request.Rejected claims must be corrected and resubmitted. Neither the reopening nor redetermination process is able to address rejected claims.Refer to each LCD for specific guidance on the use of these modifiers. |
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