Important Coding Information with Regard to DME Modifiers

Date Issued: 3/25/2015

To help EmblemHealth process claims accurately for Durable Medical Equipment (DME) services, please follow these coding instructions when submitting claims:

  • Bill “payment modifier” in the first modifier position (for accurate claim adjudication).
  • Bill the KX modifier in the second modifier position for DME HCPCS codes that require a KX modifier.
  • DME services that require three or more modifiers must have all applicable modifiers for accurate claim payment.

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