DME MAC A Discusses Appropriate KE Modifier Usage
NHIC Corp., the Jurisdiction A DME MAC, has sent out a news release reminding DME suppliers about proper usage of the KE modifier starting this month.
In a Dec 31 e-mail to its listserv, NHIC said, “Suppliers must use the KE modifier to identify when the same accessory HCPCS code can be furnished in multiple competitive and non-competitive bidding product categories.
“For example, HCPCS code E0981 -- Wheelchair Accessory, Seat Upholstery, Replacement Only, Each -- can be used with both competitively bid standard and complex rehabilitative power wheelchairs (K0813 through K0829, and K0835 through K0864), as well as with non-competitively bid manual wheelchairs (K0001 through K0009) or a miscellaneous power wheelchair (K0898).
“The KE modifier would be appended to the E0981 if it is an accessory for a K0001 manual wheelchair (the non-competitively bid base item).”
The NHIC message added, “The KE modifier is used to identify an accessory code that can be dually billed with either a competitive or non-competitive bid base item. The KE modifier must be appended to the accessory code if it is billed with a non-competitively bid base item.”
KE modifiers should NOT be used “on any claims for items that were included under Round 1 of competitive bidding, such as an accessory for a standard or complex rehabilitative power wheelchair,” the e-mail said.
This rule became effective on Jan. 1.