What is kx modifier physical therapy

The service delivered beyond that require a KX modifier that indicates that the service meets the criteria for payment exception. Even though the CMS did not receive additional funding to conduct these reviews, that is the current plan.

These also include the services provided by hospital outpatient departments. Right now, there are three tips that we advise you to use when going for the KX modifier for outpatient therapy — in order to stay out of trouble.

This integration can reduce any errors leading to claims denials, speed up your overall insurance billing process, and ensure that you get properly reimbursed for the services you provide. Platform Features. Physical Therapy Outpatient Modifiers for Discover new physical therapy modifiers for and how they can impact your practice.

Health software that makes a difference Focus on clinic growth and patient care with Healthie. Learn More. Related Articles. Learn how digital billing can benefit physical therapy practices. Find out why virtual billing is more efficient than paper forms. Hi Keith, Thanks for your question.

Given that your information is only is good as of the time you verify via your MACs look-up tool , there is no harm by being a off a bit. It is better to apply the modifier just prior to reaching the cap to save yourself having to do a clerical reopening to append the modifier if the claims was denied for being over the cap.

Some MACs have issued warnings about applying the KX modifier well in advance of the patient reaching the cap. Hi Nancy, I have a question regarding the kx modifiers and who can actaully put them on the charges. I work at a facility that has outpatient pt,ot and speech as well as inpatient ltac and snf. My question is, do the kx modifiers have to be added by the therapist who saw the patient or can a coder add those. Also, can an auditor who is not clinical nor a coder add those?

Sometimes the ltac and snf patients are sent to add kx modifiers after they have been denied by Medicares part A becuase of exhausted benefits. Thanks for your assistance. Hi Julie — Thank you for your comment. Both modifiers cannot be used on the same claim lines. When also using AT modifier, does it matter if KX is in first position: i. Pt hasnt reached, it was just added in error. Will claims be denied or do you have to use it from then on out? We have a patient that has met his medicare cap for previous treatment.