What is CPT A4452?

What is CPT A4452?

A4452 – HCPCS Code for Tape, waterproof, per 18 square inches.

What is the AU modifier used for?

AU – Item furnished in conjunction with a urological, ostomy, or tracheostomy supply. AV – Item furnished in conjunction with a prosthetic device, prosthetic or orthotic. AW – Item furnished in conjunction with a surgical dressing.

What is KF modifier for Medicare?

Modifier KF is a pricing modifier. The HCPCS codes for DME designated as class III devices by the FDA are identified on the DMEPOS fee schedule by presence of the KF modifier.

What is the ABN modifier?

This modifier indicates that an ABN is on file and allows the provider to bill the patient if not covered by Medicare. Use of this modifier ensures that upon denial, Medicare will. automatically assign the beneficiary liability.

Is KX modifier still valid?

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. That means you must continue to track your patients’ progress toward the threshold so you know when to affix the modifier.

What is a GZ modifier for Medicare?

The GZ modifier indicates that an Advance Beneficiary Notice (ABN) was not issued to the beneficiary and signifies that the provider expects denial due to a lack of medical necessity based on an informed knowledge of Medicare policy.

Is modifier KX only for Medicare?

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.

How do I install a 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.

Is the KX modifier only for Medicare?

Why was my a4450 claim rejected?

Claims for tape (A4450 and A4452) which are billed without an AW modifier (see Coding Guidelines section) or another modifier indicating coverage under a different policy will be rejected as missing information. When dressings are covered under other Medicare benefits, there is no separate payment using surgical dressing codes.

Which HCPCS codes require the AU modifier when billing?

No other HCPCS codes require the use of the AU modifier when billing. Any claims submitted with a HCPCS identified above that does not have the appropriate modifier appended as per the policy with which it is billed, will be denied as noncovered.

What is the AU modifier for ostomy supplies?

Modifier AU. Item furnished in conjunction with a urological, ostomy or tracheostomy supply. The HCPCS codes indicated below are the only codes for which the AU modifier may be used. No other HCPCS codes require the use of the AU modifier when billing. Ostomy Supplies Local Coverage Determination (LCD) A4450.