For the Week of October 27, 2014
Would you clarify the use of modifier KX for the fourth PET scan for subsequent treatment strategy? Are hospitals required to use this modifier, or is it just for physicians?
Both hospitals and physicians (and non-hospital imaging centers) need to add modifier KX (requirements specified in the medical policy have been met) to the fourth or greater subsequent treatment strategy PET scan claim. For more on the modifier, see transmittal 2932 at http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2932CP.pdf.
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