BILLING NEWS

KX Modifier Facilitates Claims for Transgender Services

Effective for dates of service on or after August 1, 2017, modifier KX (requirements specified in the medical policy have been met) may be used to facilitate claim processing in instances where the patient's gender conflicts with the billed procedure code. The patient's medical record must support medical necessity for the procedure. Providers may already override a gender conflict with an approved Treatment Authorization Request (TAR) or Service Authorization Request (SAR) when the gender on the claim conflicts with the billed procedure code. Use of modifier KX introduces an alternative method to facilitate claims processing without requiring an approved TAR or SAR. The use of modifier KX will not override other policy requirements for an approved TAR or SAR.


SOURCE: General Medicine | July 2017 | Bulletin 517
INDUSTRY NEWS TAGS: California Medi Cal


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