As a reminder, the following changes will be made to informational modifiers used to process high liter-flow oxygen claims beginning April 1, 2017.
The most notable change will affect how you bill for high liter flow equipment when the patient is using stationary and portable equipment. The affects claims billing out with the QF modifier. Effective April 1, 2017, you must separately bill for the portable unit for your claims to pay correctly.
Claim processing logic has been slightly modified for scenarios when the QG modifier is used. The end result is to implement logic to force denials if there is conflicting evidence of portable equipment on file during a period where the QG modifier is billed. As a reminder, the QG states that the beneficiary is only using stationary equipment. If portable is added at a later date, the correct modifier to use is the QF modifier.
The most notable change will affect how you bill for high liter flow equipment when the patient is using stationary and portable equipment. The affects claims billing out with the QF modifier. Effective April 1, 2017, you must separately bill for the portable unit for your claims to pay correctly.
Claim processing logic has been slightly modified for scenarios when the QG modifier is used. The end result is to implement logic to force denials if there is conflicting evidence of portable equipment on file during a period where the QG modifier is billed. As a reminder, the QG states that the beneficiary is only using stationary equipment. If portable is added at a later date, the correct modifier to use is the QF modifier.
In early March, CMS revised Change Request 9848 to add BR.9848.10, which reads:
The contractors shall update the system to accept and process the QF modifier on the CBIC HCPCS file. All other information in the CR was unchanged.
If you and your staff want to increase your comfort level with vetting oxygen medical records, you can order the on-demand playback of our recent webinar, Clearing the Air: Evaluating Oxygen Coverage with Medical Records, for just $99!
The contractors shall update the system to accept and process the QF modifier on the CBIC HCPCS file. All other information in the CR was unchanged.
If you and your staff want to increase your comfort level with vetting oxygen medical records, you can order the on-demand playback of our recent webinar, Clearing the Air: Evaluating Oxygen Coverage with Medical Records, for just $99!
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