Modifier Coding Alert
KX Directs the Payers to the Medical Record for Justification
Question: My doctor has a patient with non-reversible symptomatic bradycardia and the doctor inserted a pacemaker. I received a denial when I reported 33206. Do I need a modifier?
Maryland Subscriber
Answer: You need to append modifier KX (Requirements specified in the medical policy have been met) to 33206 (Insertion of new or replacement of permanent pacemaker with transvenous electrode[s]; atrial) to communicate to your payer that the patient’s medical record states that the patient has non-reversible symptomatic bradycardia.
Your doctor’s documentation must include the condition and that the bradycardia is due to sinus node dysfunction or due to second or third degree atrioventricular block for Medicare approval.
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