Top Modifiers Used In DME Billing
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Top Modifiers Used In DME Billing
Durable Medical Equipment billing is a highly complicated billing process 
as it involves several inclusions.
 Missing out even a minute detail can lead to rejection or denial of the 
claims. Modifiers play a crucial role in such billings apart from the HCPCS 
codes as per the DME supplies. 
Modifiers provide the details and the description of the DME items and 
decide on the claims processed on DME. Along with the HCPCS codes, the 
DME medical billing also uses the ICD-10 diagnosis code. These codes 
determine the medical condition for which the DME item was prescribed 
in the first place.
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Modifiers- A Look
All HCPCS codes do not require a modifier, but most of them come 
along with one. A modifier mentions whether the DME item is new 
or used, or rented on a capped mode. In case the DME is on capped 
rental, only the modifiers can show the difference in which month 
the DME billing is being done.
Common Modifier:
 RR: Rental
 NU: New Equipment Purchase
 UE: Used Equipment Purchase
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Categories for which Common Modifiers are used:
Modifiers RR, NU, and UE can be used for the following 
categories:
•Oxygen Equipment (without contents)
•Capped Rental Items
•Items with the need for Substantial and Frequent Servicing
•Inexpensive and Routinely Purchased items
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Maintenance and Servicing:
MS is the modifier used for the six-month maintenance and servicing fee. This 
modifier is used for labor and parts that remain uncovered under any supplier or 
manufacturer’s warranty. Moreover, the payments for maintenance and service 
are made every 6 months but only after the equipment is initially owned by the 
member.
Replacement and Repair
RA is a modifier that is applicable for a DME item replacement with respect to non-
repair damage, theft, or loss. However, this DME code needs to be used only for 
the first-month rental claim for a replacement DME item
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KX Modifier: Documentation on File
The KX Modifier indicates the existence of required documentation on file to support the 
DME item’s medical necessity. This modifier is applicable for the following categories:
•Hospital beds
•Walkers
•Orthopedic footwear
•Patient lifts
•CPAP
•Wheelchair seating
•Pre-fabricated knee orthoses
•Cervical traction unit
•External infusion pumps
•Nebulizers
•Commodes and many more
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Right and Left Modifiers:
RT: For Right
LT: For Left
Modifiers RT and LT can be used for the following categories:
•External breast prosthesis
•AFO/ KAFO
•Orthopaedic footwear
•Eye prosthesis
•Lower limb prosthesis
•Therapeutic shoes for diabetic persons
•Wheelchair options/ accessories
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Conclusion
These modifiers are just part of DME billing, and there are multiple more modifiers that 
are required to be specified and remembered while submitting the claims.
 However, practically it is not that easy for your DME practice to balance patient care 
and DME billing with the correct modifiers. 
It would be better to outsource DME medical billing in India rather than training in-
house professionals for such knowledge. 
Connect with the Info Hub experts right now and get rid of DME medical billing 
stress. 
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