Make Your Modifier List and Check It Twice

BALTIMORE — If you thought the KX was tough to get a
handle on, try this recently released list of new claims modifiers
for use under competitive
bidding:

• J4 – DMEPOS item subject to DMEPOS competitive bidding program
  that is furnished by a hospital upon discharge.
• KG – DMEPOS item subject to DMEPOS competitive bidding program
  Number 1.
• KK – DMEPOS item subject to DMEPOS competitive bidding program
  Number 2.
• KU – DMEPOS item subject to DMEPOS competitive bidding program
  Number 3.
• KW – DMEPOS item subject to DMEPOS competitive bidding program
  Number 4.
• KY – DMEPOS item subject to DMEPOS competitive bidding program
  Number 5.
• KL – DMEPOS Item delivered via mail.
• KV – DMEPOS item subject to DMEPOS competitive bidding program
  that is furnished as part of a professional service.
• KT – Beneficiary resides in a competitive bidding area and
  travels outside that competitive bidding area and receives a
  competitive bid item.

For an explanation of the new modifiers, how to use them and who
should use them, see MLN Matters article SE1035, posted Dec. 27 on
the CBIC website under “What’s New.”

According to the article, the KG, KK, KU, KW, and KY modifiers
are modifiers that identify when the same supply or accessory HCPCS
code is furnished in multiple competitive bidding product
categories or when the same code can be used to describe both
competitively and non-competitively bid items.

In addition, the article notes, all suppliers must use the KE
modifier (added to the DMEPOS fee schedule file in 2009) on all
Part B fee-for-service claims to identify when a Round I bid
accessory item is used with a non-competitively bid base item (an
item that was not competitively bid prior to July 2008).

View more competitive bidding
stories.