Nebulizer Drugs with KO Modifier - Mass Adjustments

Provider/Supplier Type(s) Impacted: Suppliers billing Nebulizer Drugs with KO Modifier

Reason Codes: Not Applicable.

Claim Coding Impact: Suppliers billing KO fees for J7605, J7606, J7608, J7613, J7614, J7626, J7631, J7639, J7644, J7682 and receiving incorrect payments.

Description of Issue: Nebulizer drugs with the KO modifier received on or after 04/01/20 for dates of service (DOS) on or after 04/01/20 were priced incorrectly at the 2020 Q1 fee amounts and not the 2020 Q2 fee amounts.

Noridian Action Required: Noridian will adjust affected claims for DOS 04/01/20-05/13/20

Provider/Supplier Action Required: None

Proposed Resolution/Solution: Noridian will initiate mass adjustments.

Date Reported: 05/18/20

Date Resolved:

Last Updated May 19, 2020