Wiki KX modifiers on Pacemakers

alicia

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There is confusion in our office regarding the KX modifier usage on pacemakers.

It is understood that you need certain CPT, HCPCS, and Diagnosis codes but what is confusing is when they talk about the "non-reversible symptomatic bradycardia". Must this be documented in the record or is it assumed.

Any thoughts are greatly appreciated.
:confused:
 
See if this helps. The physician needs to document, "patient has non-reversible symptomatic bradycardia due to sinus node dysfunction or second and/or third degree atrioventricular block."

The "KX" modifier is appended on the claim as an attestation by the provider indicating "documentation is on file verifying the patient has non-reversible symptomatic bradycardia"

All claims will be denied without this information and for all other dx codes.

https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNMattersArticles/Downloads/MM8525.pdf

HTH
 
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