Article Detail - JD DME

Original Effective Date: 07/01/2000
Revision Effective Date: 11/01/2013

Claims denied due to the lack of a ZX modifier are frequently seen in appeals accompanied only by a statement that the supplier forgot to add the ZX modifier. If the appropriate documentation substantiating the beneficiary met criteria is not submitted, the Review Department will no longer add the ZX modifier to claims with this or other similar statements. Effective immediately, reviews for claims without a ZX modifier that are submitted without the appropriate documentation will be developed for the documentation that the ZX represents, based on the relevant policy.