Wiki DME Billing to Medicare-HELP!!!!!!

[Ghrnndz823]

Hi!

I'm getting continuous rejections from Medicare for DME products. For example, I've billied L4361(Walking Boot) with and without mod NU, RT/LT and without a modifier but Medicare denies the claim saying "procedure code is inconsistent with modifier used or a required modifier is missing". I just submitted the claim to DMERC with a KX mod in hopes that it gets paid.

Am I missing something?

Thanks in advance!
Giselle
New to Ortho billing.
Southern California

 

[midnight1995]

Dme

I am not sure what state you are in - Medicare DME has part B jurisdictions with LCD policy's this will give you the medical necessary needed, modifiers and any other information for documentation.

 

[RyanRaichCPC]

I always append KX to DME for lower extremity when billing to DMERC. Hopefully this will pay now that you have KX on there. What POS are you using?