For Medicare: If you primary dx is any of the following codes do not need to append the QO modifier:
If your primary dx is not one of the above; such as: 428.22, 412 or 425.4 you will need to append Q0 modifier.
"Just make sure to attach the Q0 (Q-Zero) modifier to all primary prevention implants along with a diagnosis code that is in line with the appropriate primary prevention indication(s), such as: 428.22 (Chronic systolic heart failure), 412 (Old myocardial infarction), or 425.4 (Other primary cardiomyopathies)."
I got this information from the EP digest article by Jim Collins, Zhealth and NCD. We do not recieve denials on our 33249.
Do not use Q0 if it is a commercial carrier.
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