Changes are coming to high liter-flow oxygen claims beginning April 1, 2017. Change Request (CR) 9848 is modifying claims processing logic in relation to two informational modifiers used to indicate that the beneficiary has been prescribed a high liter-flow and has achieved qualifying test results on the minimum of 4 LPMs: the QF modifier for portable equipment and the QG modifier for stationary equipment.
After April 1, 2017:
After April 1, 2017:
- When a patient has stationary and portable equipment, suppliers should bill both stationary HCPCS and portable HCPCS using the QF modifier. The stationary unit will be paid at standard rates and the portable equipment will be paid at the higher fee schedule rate of the volume adjustment (50% of stationary) or portable add-on rental rate. The QF logic is shifting and will require the portable to be billed in order to procure the maximum reimbursement rate under this new guidance.
- When a patient has only stationary equipment, suppliers should bill stationary HCPCS using the QG modifier. The stationary unit will be paid at 150% of standard rates. The QG modifier is to be used for patients who only have stationary equipment. If this is guidance is not followed, the claim will be rejected.
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