DME Medical Billing Modifiers – All You Need to Know
                     DME MEDICAL BILLING MODIFIERS – ALL YOU 
NEED TO KNOW
Durable medical equipment (DME) billing is a highly complicated 
process since it involves too many inclusions and a small 
detailing miss out may lead to rejection/denial of claims. In such 
additions, modifiers play an important role along with HCPCS 
codes according to the DME supplies. Modifiers provide the 
detailing/description of the DME item and decides the 
processing of claims raised on DME. Along with HCPCS code, 
DME medical billing also includes an ICD-10 diagnosis code that 
determines the medical condition for which the item has been 
prescribed.
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Modifiers-a look
Not all HCPCS code requires a modifier to be added but most of it 
comes along with a modifier. Basically, a modifier conveys 
whether the item is new, used or rented on a capped basis, and 
when it comes to capped rentals, only modifiers show the 
difference of which month’s DME bill is being billed. Specifying 
these modifiers incorrectly can lead to rejection or denial of 
claims. Let us look at the commonly used modifiers in DME 
medical billing.
Common modifiers – RR for rental
NU for purchase of new equipment
UE for purchase of new equipment
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Categories for using common modifiers
Use modifiers RR, NU and UE for the following 
categories:
Capped rental item
Oxygen equipment without contents
Items that require frequent and substantial servicing
Routinely purchased items or inexpensive ones
When it comes to capped rentals, along with RR, the 
following modifiers should be added to determine the 
rental period:
KH- for initial claim and first-month rental
KI- for second and third-capped rental
KJ- from fourth to thirteenth capped rental months
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Maintenance and servicing
MS is the modifier that is used for a 6-month maintenance and 
servicing fee for required parts and labour that are not covered 
under any warranty of the supplier or the manufacturer. 
Moreover, maintenance and service payments are made every 
six months only after the member initially owns the equipment.
Replacement and repair
RA is the DME code applicable for the replacement of a DME item 
due to loss, non-repairable damage, or theft. But this modifier 
should be used only for the first month rental claim for a 
replacement item.
RB is again a modifier that is applicable on replacement of a part 
of DME with respect to repairs if any.
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KX modifier for documentation on file
The KX modifier represents the presence of required documentation is on 
file to support the medical necessity of the item. The KX modifier is 
allowed for the following categories:
•Cervical traction unit
•External infusion pumps
•Hospital beds
•Nebulizers
•Orthopaedic footwear
•Patient lifts
•Pre-fabricated knee orthoses
•Walkers
•Wheelchair options or accessories
•CPAP
•Wheelchair seating
•Commodes and more
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Conclusion
So far the modifiers you have learned about is just a 
part of DME billing, and there are multiple modifiers 
that need to be remembered and specified in the 
claim form. But practically it is not possible for your 
DME practice to do it with utmost determination, 
since it is not feasible to hire and train more DME 
billing professionals to your practice. Therefore, the 
need for an expert DME billing company like 24/7 
Medical Billing Services is required to ensure smooth 
workflow and cash flow at your practice. To talk to our 
DME billing expert, make a call to +1-888-502-0537.
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ABOUT US
• We are a medical billing company that offers ‘24/7 Medical Billing Services’ and 
support physicians, hospitals, medical institutions and group practices with our end to 
end medical billing solutions. We help you earn more revenue with our quick and 
affordable services. Our customized Revenue Cycle Management (RCM) solutions 
allow physicians to attract additional revenue and reduce administrative burden or 
losses.
• Our company was founded in 2005 and is now a leading organization of highly 
motivated and certified coders & billers in the US medical billing industry. Our current 
employee strength is 500+ and we have ambitious plans to grow more rapidly.
• As a leading Medical Billing Outsourcing Company we take care of the complete setup 
& enrolment in about one to four weeks time depending on the complexity of the 
project. We have certified trainers with 10+ years of experience to train the 
newcomers so they can get acquainted with the specialty jargons & stay updated with 
the recent coding developments.
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CONTACT US
24/7 Medical Billing Services
16192 Coastal Hwy,
Lewes, DE – 19958
USA
Phone no : 
+1 888-502-0537
Email Address :
[email protected] 
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