# TENs unit and Medicare



## inc1961 (Mar 22, 2017)

Good afternoon,

I am looking for guidance on billing a TENs unit to Medicare.
E0720.  We used modifier NU (new) initially but that was rejected.
We used modifier KX (greater than 3 months pain) and the claim was denied for POS.
Medicare is stating this can only be billed by inpatient and outpatient hospitals?

Has anyone had recent success billing TENs units to Medicare.  The patient takes home the unit.

Thank you


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## thomas7331 (Mar 22, 2017)

Which Medicare carrier are you billing this to - are you getting these denials from the DMERC or from your local MAC?


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## inc1961 (Mar 22, 2017)

We bill to both Novitas (NJ) and NGS (NY).  However, these denials are for the local MAC., not DMERC  The provider is not  DME provider, which may likely be the cause.  Novitas cannot give me a definitive answer.  

Thank you


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## thomas7331 (Mar 23, 2017)

I think that's probably what is behind the denials.  This is a DME that item isn't on the physician fee schedule so it won't be able to be paid by the Part B MAC - the provider would need to enroll with and bill to the DMERC.


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## inc1961 (Mar 23, 2017)

Thank you for your feed back.  I told the provider this prior to billing, but I was hoping there was some other reason we were being denied.

Really appreciate your help!


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