AAPC - Back to school
Results 1 to 4 of 4

Thread: Billing DMREC

  1. #1
    Join Date
    Apr 2007
    Rome, GA

    Default Billing DMREC

    AAPC: Back to School
    I need some help in billing DMREC for parenteral nutrition supplies (Pumps, administration kits, supply kits, nutrition solutions, etc). We are billing:
    B9004 with a KJ modifier for the pump.
    B4224 for the administration kit,
    B4220, supply kit, premix.
    B4185 solution, per 10 grams lipids and
    B4189, soluation....premix.

    We keep getting denied for procedure/modifier invalid. We are in Georgia. Any help would be greatly appreciated. Thanks in advance.


  2. #2

    Default Dmrec

    Hi pygreen,

    Do you have access to Ingenix Encoder Pro?

    You can enter the codes and in that database all the modifiers that can be billed with any CPT or HCPCS code will be listed.

    Now you may want to contact the payer because they may have in their system what modifiers are appropriate for what codes and which modifers are not.

    Hope this helps.

    happycoder07 = Pedenia Evans, CPC

  3. #3


    I suspect it could be the modifier that's causing your denial. It is important to use the modifier that indicates the correct rental month. The first three months of a capped rental item is calculated to limit the monthly rental to 10% of the allowed purchase price. Therefore, the KH modifier must be used on the first month and KI on the second and third months.

    For each additional month, the allowance is reduced to 7.5% of the allowed purchase price. Therefore, the KJ modifier must be used for months four through thirteen.

    If you're sure the monthly count is correct, call the payor (as painful as that sometimes is).

  4. #4
    Join Date
    Apr 2007
    Rome, GA


    Thanks Julie. The modifer is correct. This DOS falls witin that range of months. I wanted to check and make sure the code was correct before I called the Carrier.

Similar Threads

  1. Replies: 2
    Last Post: 04-24-2015, 04:20 PM
  2. Replies: 0
    Last Post: 08-24-2012, 08:09 PM
  3. CPC owner of Medical billing service offers remote billing
    By dfallows in forum Resume Postings
    Replies: 0
    Last Post: 06-18-2008, 12:11 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.