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FAQ: What Is The Modifier For Dme Not Related To The Hospice Diagnosis?

What does the AH modifier mean?

Description. HCPCS Modifier AH — clinical psychologist.

What is modifier KX used in DME?

KX – The KX modifier should be added to the code to indicate that specific required documentation is on file to support the medical necessity of the item.

What is the GY modifier used for?

The GY modifier is used in medical billing to indicate that the service is statutorily excluded by Medicare.

What is the 59 modifier?

Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances.

What is a U4 modifier?

U4 – Medicaid level of care 4, as defined by each state. The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.

What is modifier F6?

F5: Right Hand, Thumb. F6: Right Hand, Second Digit.

What does modifier KX stand for?

Modifier KX

Requirements specified in the applicable Local Coverage Determination (LCD) have been met. Use of the KX modifier indicates that the supplier has ensured coverage criteria for the billed is met and that documentation does exist to support the medical necessity of item.

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What is the CG modifier?

You should report modifier CG on one line with a medical and/or a mental health Healthcare Common Procedure Coding System (HCPCS) code that represents the primary reason for the medically necessary face-to-face visit.

What is the modifier for DME purchase?

NU — NEW DURABLE MEDICAL EQUIPMENT PURCHASE. This modifier is used for new DME items that are purchased. When using the NU modifier, you are indicating you have furnished the beneficiary with a new (never used) piece of equipment.

Can we bill patient for GY modifier?

Modifier GY will cause the claim to deny with the patient liable for the charges. Do not use on bundled procedure or on add-on codes. You may use this modifier in combination with the GX modifier.

What is the 26 modifier?

The CPT modifier 26 is used to indicate the professional component of the service being billed was “interpretation only,” and it is most commonly submitted with diagnostic tests, including radiological procedures. When using the 26 modifier, you must enter it in the first modifier field on your claim.

What is a 51 modifier?

Modifier 51 Multiple Procedures: use Modifier 51 to indicate that multiple procedures (other than E/M) were performed at the same session by the same provider. Modifier 51 is used to identify the second and subsequent procedures to third party payers.

What is a 25 modifier?

Modifier 25 (significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the procedure or other service) is the most important modifier for pediatricians in Current Procedural Terminology (CPT®).

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