KF Modifier Use Correct Coding

Joint DME MAC Publication

Suppliers are reminded that devices classified by the Food & Drug Administration (FDA) as Class III devices must be billed using the KF modifier (ITEM DESIGNATED BY FDA AS CLASS III DEVICE).  The following HCPCS codes and their associated Local Coverage Determinations (LCD) have devices where the KF modifier is applicable:

HCPCS Code Descriptor LCD
E0617 EXTERNAL DEFIBRILLATOR WITH INTEGRATED ELECTROCARDIOGRAM ANALYSIS Automatic External Defibrillators
E0747 OSTEOGENESIS STIMULATOR, ELECTRICAL, NON-INVASIVE, OTHER THAN SPINAL APPLICATIONS Osteogenesis Stimulators
E0748 OSTEOGENESIS STIMULATOR, ELECTRICAL, NON-INVASIVE, SPINAL APPLICATIONS Osteogenesis Stimulators
E0760 OSTEOGENESIS STIMULATOR, LOW INTENSITY ULTRASOUND, NON-INVASIVE Osteogenesis Stimulators
E0766 ELECTRICAL STIMULATION DEVICE USED FOR CANCER TREATMENT, INCLUDES ALL ACCESSORIES, ANY TYPE Tumor Treatment Field Therapy
K0553 SUPPLY ALLOWANCE FOR THERAPEUTIC CONTINUOUS GLUCOSE MONITOR (CGM), INCLUDES ALL SUPPLIES AND ACCESSORIES, 1 MONTH SUPPLY = 1 UNIT OF SERVICE Glucose Monitors
K0554 RECEIVER (MONITOR), DEDICATED, FOR USE WITH THERAPEUTIC GLUCOSE CONTINUOUS MONITOR SYSTEM Glucose Monitors
K0606 AUTOMATIC EXTERNAL DEFIBRILLATOR, WITH INTEGRATED ELECTROCARDIOGRAM ANALYSIS, GARMENT TYPE Automatic External Defibrillators
K0607 REPLACEMENT BATTERY FOR AUTOMATED EXTERNAL DEFIBRILLATOR, GARMENT TYPE ONLY, EACH Automatic External Defibrillators
K0608 REPLACEMENT GARMENT FOR USE WITH AUTOMATED EXTERNAL DEFIBRILLATOR, EACH Automatic External Defibrillators
K0609 REPLACEMENT ELECTRODES FOR USE WITH AUTOMATED EXTERNAL DEFIBRILLATOR, GARMENT TYPE ONLY, EACH Automatic External Defibrillators

 

For items classified by the FDA as a Class III device that do not have a specific HCPCS code assigned, use HCPCS code E1399 (DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS) with the KF modifier appended.

The following HCPCS code also has products which are classified by the FDA as Class III devices.  Although not associated with a specific LCD, the KF modifier is required for claim submission of this HCPCS code as well.

HCPCS Code Descriptor LCD
E0764 FUNCTIONAL NEUROMUSCULAR STIMULATION, TRANSCUTANEOUS STIMULATION OF SEQUENTIAL MUSCLE GROUPS OF AMBULATION WITH COMPUTER CONTROL, USED FOR WALKING BY SPINAL CORD INJURED, ENTIRE SYSTEM, AFTER COMPLETION OF TRAINING PROGRAM None (see National Coverage Determination 160.12 at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/ncd103c1_Part2.pdf)

 

This information will be added to the applicable LCD-related Policy Articles in an upcoming revision.  Please see the applicable Policy Articles for specific information.

Publication History

Publication Date Description
08/29/19 Originally Published

 

Last Updated Wed, 19 Feb 2020 15:54:54 +0000