Attestation content for KX 33208

[codeforever]

Question on KX modifier- Our docs are asking. Patient has symptoms of the CHF, with the bradycardia and rates. Do they attest on their notes etc. Appeals have been sent but not accepting documentation.

 

[Chelle-Lynn]

By using KX you are stating that your claim has met specific documentation requirements in the policy. Documentation should be present that justifies why the beneficiary qualifies for medically necessary service in excess of the cap. The documentation would be in the medical records. Justification should include


Patients medical condition and diagnosis
Services provided; type, frequency, duration
An overview of the patients condition and progress
A statement of medical necessity to support further services

Example:
Mrs. Johnson has been affected by existing dx of RA which has affected her ability to heal or perform mobility tasks following knee surgery. As noted in the documentation significant progress has been made but PT treatment is still medically reasonable and necessary to progress toward long term care plan of independence as prior to the injury.
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