DME Modifiers use for DME Durable Equipment Billing | How to Bill for DME

DME Modifiers use for DME Durable Equipment Billing

  • MODIFIER BP – The beneficiary has been informed of the purchase and rental options and has elected to purchase the item
  • MODIFIER BU The beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decision
  • MODIFIER KH – DMEPOS item, initial claim, purchase or first month rental
  • MODIFIER KI – DMEPOS item, 2nd or 3rd month rental
  • MODIFIER KX – Requirements specified in the medical policy have been met
  • MODIFIER LL – Lease/rental (use the LL modifier when DME equipment rental is to be applied against the purchase price)
  • MODIFIER NR – New when rented (use the NR modifier when DME which was new at the time of rental is subsequently purchased)
  • MODIFIER NU – New equipment
  • MODIFIER RA – Replacement of a DME, orthotic or prosthetic item
  • MODIFIER RB – Replacement of a part of a DME, orthotic or prosthetic item furnished as part of a repair
  • MODIFIER RR – Rental (use the RR modifier when DME is to be rented)
  • MODIFIER KH – DMEPOS item, initial claim, purchase or first month rental
  • MODIFIER KI – DMEPOS item, 2nd or 3rd month rental
  • KR – Rental item, billing for partial month
  • KX – Requirements specified in the medical policy have been met
  • LL – Lease/rental (use the LL modifier when DME equipment rental is to be applied against the purchase price)
  • MS – Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty NR New when rented (use the NR modifier when DME which was new at the time of rental is subsequently purchased)
  • NU – New equipment
  • QJ – Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 CFR 411.4(B)
  • MODIFIER RA – Replacement of a DME, orthotic or prosthetic item
  • RB – Replacement of a part of a DME, orthotic or prosthetic item furnished as part of a repair
  • RR – Rental (use the RR modifier when DME is to be rented)
  • UE – Used durable medical equipment
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Medical Billing DME | DMEPOS EXEMPTIONS for Accreditation and Surety | For Physicians, Non-Physicians, Physical Therapist and Occupational Therapists

 

Useful References for DME Billing

DME POS PLACE OF SERVICE CODES – https://med.noridianmedicare.com/web/jadme/claims-appeals/claim-submission/pos

DMEPOS FEE SCHEDULE – https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.html

Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Supplier Standards – (please copy and paste the link) http://www.palmettogba.com/palmetto/providers.nsf/DocsCat/Providers~National%20Supplier%20Clearinghouse~Supplier%20Enrollment~Standards%20Compliance~DMEPOS%20Supplier%20Standards~7GLS7Z1267

Medicare Enrollment Form for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers – (please copy and paste the link) – https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855s.pdf

Medicare Durable Equipment Claims Processing Manual http://www.mspinkymaniri.com/wp-content/uploads/2016/03/Chapter-20-Durable-Medical-Equipment-DMEPOS-Medicare-Claims-Processing-Manual-Rev-3196-02-13-15.pdf

 

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