Wiki Facet Joint Injections LCD Policy Question

[lcole7465]

My provider has started documenting for a 2nd diagnostic MBB injection and according to the LCD policy - "The KX modifier should be appended to the line for all diagnostic injections. In most cases the KX modifier will only be used for the two initial diagnostic injections. If the initial diagnostic injections do not produce a positive response as defined by the policy and are not indicative of identification of the pain generator, and it is necessary to perform additional diagnostic injections, at a different level, append the KX modifier to the line. Aberrant use of the KX modifier may trigger focused medical review."

My question is should I be adding the "KX" modifier to the 2nd MBB injection? He doesn't use any steroid only Bupivacaine on these MBB's. I don't want to over use the modifier.

Thank you in advance

 

[jkyles]

My provider has started documenting for a 2nd diagnostic MBB injection and according to the LCD policy - "The KX modifier should be appended to the line for all diagnostic injections. In most cases the KX modifier will only be used for the two initial diagnostic injections. If the initial diagnostic injections do not produce a positive response as defined by the policy and are not indicative of identification of the pain generator, and it is necessary to perform additional diagnostic injections, at a different level, append the KX modifier to the line. Aberrant use of the KX modifier may trigger focused medical review."

My question is should I be adding the "KX" modifier to the 2nd MBB injection? He doesn't use any steroid only Bupivacaine on these MBB's. I don't want to over use the modifier.

Thank you in advance

Hi there, yes you must use the KX modifier on diagnostic blocks. It is the only way to let the MAC know the provider is not trying to bill a therapeutic block, which is restricted to cases when the patient is not a candidate for RFA.