What is Medicare KX modifier?
The KX modifier, described in subsection D., is added to claim lines to indicate that the clinician attests that services at and above the therapy caps are medically necessary and justification is documented in the medical record.
What does the KX modifier indicate?
Modifier KX Use of the KX modifier indicates that the supplier has ensured coverage criteria for the billed is met and that documentation does exist to support the medical necessity of item. Documentation must be available upon request.
Where do you put the KX modifier?
The KX modifier is appended on claims at or very close to the $1920 cap, and should not applied from the first visit, even if the therapist knows that the cap will likely be exceeded.
What does GP Modifier mean?
The GP modifier indicates that a physical therapist’s services have been provided. It’s commonly used in inpatient and outpatient multidisciplinary settings. It’s also used for functional limitation reporting (FLR), as physical therapists must report G-codes, severity modifiers, and therapy modifiers.
What does GP modifier mean?
Can you bill Kx and Ga modifiers together?
Since the KX modifier, in most cases, should be added to a HCPCS code “only if all of the coverage criteria outlined in the Indications and Limitations of Coverage section of the applicable policy have been met,” the bulletin notes that “in most cases it would not be appropriate to append the GA and KX modifiers on the …
When to use the KX modifier?
– When the original NOE was submitted; – When the NOE was returned to the hospice (RTPs) for correction or was accepted and available for correction; and – When the hospice resubmitted the NOE.
What does modifier Kx mean?
Appropriate Use: When additional documentation supports the medical requirements of the service under a valid medical policy.
How to add Kx modifier?
– Qualified for the cap exception; – Are reasonable and necessary services that require the skills of a therapist; and – Are justified by appropriate documentation in the medical record.”
What is Kx modifier used for?
The KX modifier is used by DME suppliers to ensure that the records exist and are available to support that the claim has followed Medical Policy and the LCD for that item.