BK modifiers
Darya Shahrokhi
Description
Collection
Title:
BK modifiers
Creator:
Darya Shahrokhi
Date:
9/3/2018
Text:
Regarding modifiers for BK, almost everybody said:
We need to use either Lt or Rt, depending on the amputated side, and the K level. For example L5301 Rt K2
Depending on the payor, they may need K level mentioned for all or some additional codes.
For Blue Cross, I added amputated side ADN K level for ALL codes, and looks like claim was accepted.
My personal experience with Blue Cross:
1- I use Availity to submit claims.
2- First I used NU as a modifier for all codes (because Blue Cross has been sent me list of codes that has either these: NU, RR, UE), and the claim was denied upfront.
3- After speaking with Blue Cross claim department customer service, I have been told to mail the correction, and it may take up to 30 days to reprocess. The representative also mentioned that if I submit a new electronic claim, FOR SURE it will be denied.
4- I submitted a new claim via Availity, with correct modifiers; It has been accepted! Took just few days for process.
I think most of you know, but for the ones who doesn’t know (like me), different representative tells you different answers! DO NOT trust one, and call back and speak with another one. Not bad idea to ask for their supervisor.
Darya Shahrokhi, CPO
We need to use either Lt or Rt, depending on the amputated side, and the K level. For example L5301 Rt K2
Depending on the payor, they may need K level mentioned for all or some additional codes.
For Blue Cross, I added amputated side ADN K level for ALL codes, and looks like claim was accepted.
My personal experience with Blue Cross:
1- I use Availity to submit claims.
2- First I used NU as a modifier for all codes (because Blue Cross has been sent me list of codes that has either these: NU, RR, UE), and the claim was denied upfront.
3- After speaking with Blue Cross claim department customer service, I have been told to mail the correction, and it may take up to 30 days to reprocess. The representative also mentioned that if I submit a new electronic claim, FOR SURE it will be denied.
4- I submitted a new claim via Availity, with correct modifiers; It has been accepted! Took just few days for process.
I think most of you know, but for the ones who doesn’t know (like me), different representative tells you different answers! DO NOT trust one, and call back and speak with another one. Not bad idea to ask for their supervisor.
Darya Shahrokhi, CPO
Citation
Darya Shahrokhi, “BK modifiers,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/209126.
