[Regina]

Do trapeze bars (E0910 & E0911) need KX modifiers now? And, how does everyone keep current on what requires KX modifiers? Even the LCDs don't indicate what equipment listed in the LCD requires the KX modifer.

[HEATHER]

This is right from the hospital bed and accessories LCD...
http://www.cms.gov/mcd/viewlcd.asp?l...on=36&show=all

KX, GA and GZ Modifiers

Suppliers must add a KX modifier to a hospital bed code only if all of the criteria in the “Indications and Limitations of Coverage and/or Medical Necessity” section of this policy have been met. The KX modifier should also be added for an accessory when the applicable accessory criteria are met. If the requirements for the KX modifier are not met, the KX modifier must not be used.

If all of the coverage criteria have not been met, the GA or GZ modifier must be added to a claim line for a hospital bed and accessories. When there is an expectation of a medical necessity denial, suppliers must enter the GA modifier on the claim line if they have obtained a properly executed Advance Beneficiary Notice (ABN) or the GZ modifier if they have not obtained a valid ABN.

Claim lines billed without a KX, GA or GZ modifier will be rejected as missing information.

I think that this is listed near the end of the LCD (after hcps's listing) on every item that requires this modifier.

[Regina]

ok, I feel REALLY stupid now. thanks Heather.

[DMEisgoodfun]

They do require KX.

I'm in Region D and our LCD's tell us if the product require KX. I also
created a manual for CSR's and billers that lists product, coverage
criteria, required modifiers and qty limitations. Our software also gives us
the option to add KX to the item file. We don't use this feature because it
automatically attachs to the claim. I want the billers reading the chart and
making an informed decision to add the KX.