BMBankOfMedicare.comBilling University & Reimbursement Research

Modifier Workflow

DME Rental, Purchase, Replacement, and Repair Modifiers

Connect equipment status and the rental month to the item, order, delivery, payment category, repair record, and claim history.

Research sequence

  1. 1Confirm the HCPCS payment category
  2. 2Establish new, used, rental, replacement, or repair facts
  3. 3Match the rental month to claim history
  4. 4Retain delivery, repair, and replacement support

Modifiers in this workflow

NUNew equipmentUsed when billing new equipment where applicable.DetailsRRRentalUsed for rental billing where applicable.DetailsUEUsed durable medical equipmentUsed equipment modifier where applicable.DetailsKHInitial claim, purchase or first rental monthDME rental/purchase sequence modifier.DetailsKISecond or third month rentalDME rental sequence modifier.DetailsKJFourth to fifteenth month rentalDME rental sequence modifier.DetailsRAReplacement of DME itemReplacement modifier requiring claim-specific support.DetailsRBReplacement part of DME item furnished as part of repairRepair part modifier where applicable.DetailsMSSix month maintenance and servicing feeMaintenance and servicing modifier.Details

Use current official or licensed modifier definitions and payer instructions. A modifier communicates a supported claim fact; it does not create coverage or medical necessity.