tci Part B Insider - 2012 Issue 15

Physician Note: Providers Are Appending Modifier KX Willy-Nilly, OIG Says

Plus: One health insurer learned a HIPAA lesson worth $1.5 million.Trying to ensure that your durable medical equipment (DME) claims sail through the system by slapping a modifier KX on all of them? Not so fast, the OIG says in a new report.Background: Medicare requires you to append modifier KX on certain DME claims to indicate that the claim meets Medicare coverage criteria and the supplier has the required documentation on file (such as a physician's statement of necessity). Audit findings: The OIG released a report on April 5 indicating that it sampled 400 claims with...

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