Ku dmepos item subject to dmepos competitive bidding

KU: DMEPOS item subject to
DMEPOS competitive bidding
program number three.
KW: DMEPOS item subject to
DMEPOS competitive bidding
program number four.
KY: DMEPOS item subject to
DMEPOS competitive bidding
program number five.
KH
DMEPOS item, initial claim,
purchase or first month rental
Summary
Append modifier KH to the code for
a claim for the first rental month or
purchase option of durable medical
equipment, prosthetics, orthotics,
and supplies, or DMEPOS. The
beneficiary may decide to purchase
the item at any time during the
rental period.
Modifier Explanation
Append this modifier to DMEPOS
claims for the first month of a
capped rental period.
Capped rental involves the
payment of rent for 13 consecutive
months to the supplier of the
item, while the beneficiary uses
the equipment. It covers all the
costs including reasonable repairs,
maintenance, replacement, or
other costs.
Tips
You should append the modifier
KH with modifier RR, Rental; use
the RR modifier when DME is to be
rented. The KH modifier may also
be used in conjunction with HCPCS
modifier NU, New equipment,
and UE, Used durable medical
equipment.
These modifiers do not need to be
submitted on claims for oxygen
and oxygen equipment.
KI
DMEPOS item, second or third
month rental
Summary
Append modifier KI to identify
the second or third rental month
or purchase option for durable
medical equipment, prosthetics,
orthotics, and supplies, or DMEPOS.
The beneficiary may decide to
purchase the item at any time of
the rental period.
Modifier Explanation
Append this modifier to DMEPOS
claims for the second or third
month of the capped rental period.
Capped rental involves the
payment of rent for 13 consecutive
months to the supplier of the
item, while the beneficiary uses
the equipment. It covers all the
costs including reasonable repairs,
maintenance, replacement, or
other costs.
Tips
Use the modifier KI for the second
or third month's rent of the
DMEPOS items.
You should append the modifier KI
with modifier RR, Rental; use the RR
modifier when DME is to be rented.
These modifiers do not need to be
submitted on claims for oxygen
and oxygen equipment.
For the first month rental period,
use modifier KH, DMEPOS item,
8_2016_AAE_HCPCS_Modifiers_and_Lay_Terms.indd 98 12/04/16 1:24 pm

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KJ – KO
KJ – KO
HCPCS MODIFIERS AND LAY TERMS
HCPCS MODIFIERS AND LAY TERMS
CPT® is a registered trademark of the American Medical Association. All rights reserved.
initial claim, purchase or first
month rental.
If the rental period continues past
the third month, append modifier
KJ, DMEPOS item, parenteral
enteral nutrition, pen, pump or
capped rental, months four to 15.
KJ
DMEPOS item, parenteral enteral
nutrition (PEN) pump or capped
rental, months four to fifteen
Summary
Append modifier KJ to identify
the fourth to 15th rental month
purchase option for durable
medical equipment, prosthetics,
orthotics, and supplies, or DMEPOS;
parenteral enteral nutrition pump
rental, or capped rental. The
beneficiary may purchase the item
at any time of the rental period.