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Wiki KX Modifier

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kj09

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Mechanicsburg, PA
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I have recently started doing some coding for a Physical Therapist and was told when billing for DME supplies that they must always be billed with a KX modifier. I'm trying to find documentation for support this but am not havind much luck. Any thoughts or suggestions? I thought you were only supposed to use the KX modifier when their therapy cap was met. Thanks
 
KX is appropriate for other reasons. In a nutshell, it means "I understand the coverage requirements for this service, and by using the KX modifier, I am certifying that I have met those requirements." We have several DME items that we use it for, but I wouldn't say that all automatically get it. You can search CGS Medicare's website for each HCPCS that you bill out, and the allowed modifiers will be shown, along with the coverage requirements.

Hope this helps!
 
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