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Old 03-03-2011, 11:15 AM
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Default Down coding??

I am curious how many of us obtain the required additional documentation that justifies applying the KX modifier for a semi electric HB (bundle) E0260 and if it is not obtained, how may of us are down coding to a standard HB (bundle) E2050 but setting up a E0260??

How will elimination of the Least Costly Alternative affect your decisions?
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Old 03-03-2011, 02:44 PM
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Default Down coding??

It's our normal practice to downcode if notes don't support E0260 but does
support E0255 / E0250. Least costly won't affect this practice. As I
understand it, it's not applicable to our operation because we don't
typically bill items out with the expectation that we'll take lower
reimbursement. It's a calculated decision upfront and it's billed
accordingly.
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