Quick Answer: What Is A KX Modifier?

What is a KX modifier in physical therapy?

Add the KX modifier to claim lines to indicate that you are attesting that services at and above the therapy thresholds are medically necessary, and that documentation in the patient’s medical record justifies the services..

What is the AT modifier?

The Active Treatment (AT) modifier was developed to clearly define the difference between active treatment and maintenance treatment. Medicare pays only for active/corrective treatment to correct acute or chronic subluxation. Medicare does not pay for maintenance therapy.

What is the 59 modifier?

The CPT Manual defines modifier 59 as follows: “Distinct Procedural Service: Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day.

What is modifier go used for?

Modifiers GN, GO, and GP refer only to services provided under plans of care for physical therapy, occupational therapy and speech-language pathology services. They should never be used with codes that are not on the list of applicable therapy services.

What is a 95 modifier?

95 modifier: Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system. … If your payers reject a telemedicine claim and the 95 modifier is not appropriate, ask about modifier GT.

What is a 58 modifier used for?

Staged or related procedure or service by the same physician during the postoperative period. Submit CPT modifier 58 to indicate that the performance of a procedure or service during the postoperative period was either: Planned prospectively at the time of the original procedure (staged);

What is modifier 57 used for?

Modifier 57 Decision for Surgery: add Modifier 57 to the appropriate level of E/M service provided on the day before or day of surgery, in which the initial decision is made to perform major surgery. Major surgery includes all surgical procedures assigned a 90-day global surgery period.

When should KX modifier be used?

Apply the KX modifier when you provide medically necessary services above the soft cap. Therapists should continue to affix the KX modifier to all medically necessary services above the designated limit ($2,010 in 2018), thus signaling Medicare to pay the claim.

Is KX modifier only for Medicare?

Use the KX modifier only in cases where the condition of the individual patient is such that services are APPROPRIATELY provided in an episode that exceeds the cap.

How do I install KX modifier?

By adding modifier KX to a claim, you are stating that your claim has met specific documentation requirements in the policy, and would be available upon request from the Medicare Administrative Contractor (MAC). Add this modifier to each procedure code once the specific therapy cap has been met.

What is KJ modifier?

KJ — DMEPOS ITEM, PARENTERAL ENTERAL NUTRITION (PEN) PUMP OR CAPPED RENTAL, MONTHS FOUR TO FIFTEEN. This modifier is used for capped rental DME items. When using the KJ modifier, you are indicating you are billing for months four through thirteen/fifteen of the capped rental period.