Home Health & Hospice Week

Suppliers on the hot seat again as watchdog agency takes a close look at documentation. When the HHS Office of Inspector General audited a sample of 2006 DME claims with the KX modifier, it found $127 million in estimated overpayments. Now it's looking at 2007 claims, and the results are equally grim for the industry. Background: Certain durable medical equipment items require a KX modifier for Medicare claims. The modifier indicates that the item in question has extra documentation requirements and that the supplier has the required documentation on file. For example: Respiratory assist devices require extra sleep study documentation, explains the OIG in its new report. The problem is that of a sample of 100 claims with the KX modifier from 2007 that the OIG audited, 55 lacked required documentation, according to the OIG. "The KX modifier was not effective in ensuring that suppliers of DMEPOS ... had the required [...]