# 33249 and 33225



## Kcronin1122 (Dec 19, 2017)

I am billing cpt codes 33249 and 33225, it was denied for appropriate modifier needed. This is a VA insurance.
Anyone know what modifier needs to be used?


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## twizzle (Dec 19, 2017)

Kcronin1122 said:


> I am billing cpt codes 33249 and 33225, it was denied for appropriate modifier needed. This is a VA insurance.
> Anyone know what modifier needs to be used?



Perhaps you could supply some more information by sharing the operative report.


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## thomas7331 (Dec 20, 2017)

I'm not familiar with the VA-specific requirements, but if they're following CMS rules, they may be looking for a KX modifier as an attestation that the coverage requirements have been met for this device.


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## espressoguy (Dec 20, 2017)

thomas7331 said:


> I'm not familiar with the VA-specific requirements, but if they're following CMS rules, they may be looking for a KX modifier as an attestation that the coverage requirements have been met for this device.



I've never used the KX modifier for ICDs, only pacers. More likely, if the VA follows CMS rules they would be looking for a Q0 modifier. However, this modifier is dx dependent and without the op report it is only a guess.


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## kimmyjwright (Oct 23, 2018)

The KX is not appropriate.  If following Medicare guidelines...it would be KZ...not Q0?  I was under the impression Q0 was not longer used, but a KZ was...can someone clarify?  Also, since Palmetto became effective...they want different dx.  If someone is actually getting paid for these..PLEASE RESPOND..


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