Modifier Lookup Tool - JD DME

This tool is intended to assist suppliers in determining potential modifiers that may be used in billing DMEPOS HCPCS codes. Many pricing and informational modifiers can be found by utilizing this tool.

The claim form has the ability to capture up to four modifiers. If more than four modifiers are needed, use modifier 99 (overflow) as the fourth modifier and enter the additional modifiers in the narrative field of the claim.

• Modifier placement on claim
  • First position - Pricing modifiers. i.e., RR, KH, KI, KJ, NU
  • Second position – Modifiers to indicate requirements specified in the medical policy have been met. i.e., KX
  • Other positions - Any additional informational modifiers required

Modifiers can be alphabetic, numeric, or a combination of both, but will always be two digits. Some modifiers cause automated pricing changes, while others are used to convey information only. They are not required on all HCPCS codes; however, if required and not submitted, the claim will deny as unprocessable. Be sure to distinguish between zeros and the letter "O".

Disclaimer: This tool does not include all DMEPOS modifiers or HCPCS codes and does not guarantee coverage for the item(s) billed. Refer to the Modifiers page and appropriate Local Coverage Determination and/or Policy Article for additional modifier usage.