Requirements specified in the applicable Local Coverage Determination (LCD) have been met

59 Modifier Examples An example of appropriate use of the 59 modifier might be if a physical therapist performed both 97140 (manual therapy) and 97530 (therapeutic activity) in the same visit. Normally these procedures are considered inclusive. If the 59 modifier is appended to either code, they will both be allowed on the claim separately. DMG MORI is a worldwide leader of cutting machine tools for turning and milling, as well as a comprehensive supplier in additive manufacturing using powder nozzle and powder bed. DMG MORI USA - CNC machine tools for all cutting machining applications.

Use of the KX modifier indicates that the supplier has ensured coverage criteria for the DMEPOS billed is met and that documentation does exist to support the medical necessity of item. Documentation must be available upon request.

It is recommended for suppliers to obtain a working knowledge of specific documentation requirements for specific medical policy prior to appending KX modifier as this will help prevent unnecessary rejected or denied claims.

Special modifiers on the weapon itself. Some magic weapons confer bonuses to the Attack Roll, Damage Roll, or Both. A +1 Weapon DMG, 213, for example, confers a +1 bonus to both rolls. Buffs/Other Effects. The spell Bless PHB, 219, for example, adds a d4 roll to any attack roll the target makes. Global Surgery Modifier Fact Sheet. ENews Sign Up Enter your email above. Current news from CMS and WPS GHA delivered to your inbox. Stay Connected. Newsletters Communique. To continue, please select your Jurisdiction and Medicare type, and click 'Accept & Go'. NOTE: This website uses cookies. I Do Not Accept.

Correct Use

When additional documentation is available to support medical necessity of item

Exception

Glucose Monitors and Testing Supplies LCD Documentation Requirements specifies that the KX modifier must be appended to all claims for Glucose Monitors and Testing Supplies when beneficiary is being treated with insulin injections
- If beneficiary is not being treated with insulin injections, KX modifier should not be appended

Incorrect Use

Where Did Dmg Mofifers Go Back

Append KX modifier to claim without verifying coverage criteria and existence of documentation

Appeal Option

Denied claims requiring a change specific to KX modifier, whether it be adding or removing it, must be requested via Written Redetermination only
There are no appeal rights allowed for unprocessable claims with remark code MA130. Such claims must be corrected and resubmitted

Resources

Where Did Dmg Mofifers Go Home

Active Local Coverage Determinations (LCDs)
- Ankle-Foot/Knee-Ankle-Foot Orthosis
- Automatic External Defibrillators
- Cervical Traction Devices
- Commodes
- External Infusion Pumps
- Glucose Monitors
- High Frequency Chest Wall Oscillation Devices
- Hospital Beds and Accessories
- Immunosuppressive Drugs
- Knee Orthoses
- Manual Wheelchair Bases
- Nebulizers
- Negative Pressure Wound Therapy Pumps
- Oral Antiemetic Drugs
- Orthopedic Footwear
- Patient Lifts
- Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea (Formerly CPAP)
- Power Mobility Devices
- Pressure Reducing Support Surfaces - Group 1
- Pressure Reducing Support Surfaces - Group 2
- Pressure Reducing Support Surfaces - Group 3
- Refractive Lenses
- Respiratory Assist Devices
- Speech Generating Devices
- Therapeutic Shoes for Persons with Diabetes
- Transcutaneous Electrical Nerve Stimulators (TENS)
- Urological Supplies
- Walkers
- Wheelchair Options/Accessories
- Wheelchair Seating