Crutches, Refractive Lenses and other Supplies? Be Well-versed with Modifiers

You will need to be spot on with modifiers when it comes to crutches, refractive lenses and other supplies. Read on for more information on HCPCS medical codes and modifiers relating to these:

When a patient leaves your office with crutches, you report E0110 to your MAC. However you find denials waiting for you instead. Don't be surprised as this is a common issue that practices face when dispensing equipment. So get yourself up on collecting for equipment by getting to know two important modifiers.

Modifier NU

When you give out crutches, your work is cut out for you from a billing standpoint – unless you know the correct modifiers to add to your claim. Crutches will more likely need an NU modifier and the codes for lower leg DME need a modifier KX and an RT or LT modifier in Massachusetts for Medicare. You only use the KX modifier if the patient meets the criteria set up by Medicare for the DME. But the tricky part is that those criteria can change from one state carrier to the next; as such you need to be sure to get your MAC's policy in writing.

Steps to follow: Check if there is an LCD. If it's there and the criteria are met, then the claim will need the KX modifier. After this check the fee schedule for the code. If it's on the fee schedule and there's a modifier listed, the claim will need to be billed with that modifier.

Modifier position

The modifier listed on the fee schedule must be listed in the first position. As such the claim would be billed as E0110-NU-KX. As a quick reference for accurate billing, you can keep handy the DMEPOS HCPCS codes 2011 for your jurisdiction, as well as the LCD and fee schedules.

Remember: Always review the chart note for spot on coding and correctly add the right modifiers, the documentation in the patient's chart must always support the services and modifiers billed.

KX

It's likely that you find the KX modifier handy for more than just splints and crutches. Say for instance if you are providing refractive lenses for cataract surgery patients, you will need to use KX as your go-to modifier in order to tell the payer that your physician ordered the lenses.

For more information on HCPCS codes online , sign up for a good Medical coding resource like SuperCoder. Such a site provides you with HCPCS code lookup tools to assist you in your coding.