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January 2017

Coming in March: KX modifier required for over-quantity maximum diabetic supplies

Beginning with dates of service on or after March 1, 2017, if your patients need more diabetic supplies than our quantity maximums allow, you'll be required to report the KX modifier with the diabetic supply procedure code.

If you don't report the KX modifier, your claims will reject. Reporting the KX modifier confirms that your patients meet our medical policy criteria for additional testing supplies.

Certificates of medical necessity, which include the reason for an over-quantity maximum order, are still required. We recommend that you keep the certificates in your patients’ files.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.
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