Modifier KB

Beneficiary requested upgrade for ABN, more than four modifiers identified on claim

This modifier only applies to beneficiary upgraded claims for DMEPOS where the supplier obtained an Advance Beneficiary Notice of Noncoverage (ABN) and there is a need for more than four modifiers on a claim line.

Correct Use

  • Append when using more than four modifiers. Add as fourth modifier to HCPCS code
    • CMS-1500 claims: Indicate remainder of modifiers in Item 19, include indicator to identify which line modifiers apply to
    • Electronic Media Claims (EMC): Enter remainder of modifiers in NTE segment, 2400 loop

 

Last Updated Wed, 02 May 2018 13:52:20 +0000