RETIRED - Surgical Dressings, PEN - New Modifiers

IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Article retired due to content incorporation into the applicable Local Coverage Determination or related Policy Article.

Original Effective Date: 12/12/2002           
Revision Effective Date: 11/01/2013

New modifiers have been established for use with surgical dressing codes. A new modifier has also been established for use in conjunction with parenteral or enteral nutrition (PEN).

  • A1 - Dressing for one wound
  • A2 - Dressing for two wounds
  • A3 - Dressing for three wounds
  • A4 - Dressing for four wounds
  • A5 - Dressing for five wounds
  • A6 - Dressing for six wounds
  • A7 - Dressing for seven wounds
  • A8 - Dressing for eight wounds
  • A9 - Dressing for nine wounds (This modifier should be used if there are 9 or more wounds.)
  • BA - Item furnished in conjunction with parenteral enteral nutrition (PEN) services

Modifiers A1-A9 replace modifiers X1-X9 and must be used according to the instructions in the Surgical Dressings local medical review policy (LMRP).

Modifier BA replaces modifier XA and must be used for the IV pole (E0776) according to the instructions in the Parenteral Nutrition and Enteral Nutrition LMRPs.

Modifiers A1-A9 and BA are effective for claims with dates of service on or after January 1, 2003. Modifiers A1-A9 and BA must not be used for claims with dates of service prior to January 1, 2003. Use for dates of service prior to January 1, 2003 will be returned as unprocessable or denied for incorrect coding.

There is no grace period for the use of the X1-X9 and XA modifiers. Modifiers X1-X9 and XA must not be used for claims with dates of service on or after January 1, 2003. Use for dates of service on or after January 1, 2003 will be returned as unprocessable or denied for incorrect coding. Modifiers X1-X9 and XA must continue to be used for claims with dates of service prior to January 1, 2003, regardless of the date of claim submission.

If you have already sent the DMERC a CMN for the IV pole with an XA modifier, no new CMN is required to change the modifier.

Refer to the local medical review policy on Surgical Dressings in the DMERC Region D Supplier Manual for additional information on the appropriate use of surgical dressing modifiers. The DMERC Region D Supplier Manual may be accessed online at www.cignamedicare.com/dmerc/dmsm.

 

            Last Updated Thu, 10 Jan 2019 12:36:51 +0000