Just like codes, modifiers are fair game for changes and revisions as new updates arise. Such is the case for modifier KH, defined asDMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies) initial claim, purchase, or first month rental.” Starting October 1st of this year, medical coders will no longer need to report KH for purchased capped rental durable medical equipment (DME), as well as for parenteral/enteral services and items.

According to the Centers for Medicare and Medicaid Services (CMS), local Medicare Administrative Contractors (MACs) will no longer require modifier KH in conjunction with long-term rentals for equipment such as wheelchairs. These pieces DME are known as capped rentals, and Medicare ordinarily covers them as monthly rentals rather than purchases because of their cost.

Delivery of this medical equipment typically requires a dispensing order, which includes the following information:

  • Name of the beneficiary
  • Name of the prescribing physician
  • Name and description of the piece of equipment
  • Date the order was placed
  • Prescribing physician’s signature

These types of equipment also require a new prescription for many scenarios, including:

  • All initial purchases or rentals
  • Changes in the supplier
  • Changes in the order
  • Replacement of the item
  • Anytime a new prescription is mandated by individual medical policies

Because these situations are relatively frequent, medical coders working for practices or facilities that provide DMEs should make sure to take note of this new policy for modifier KH, as it is very likely that they will encounter a new equipment claim before long. In addition, all coders, billers, and other medical professionals should be sure to keep up to date with any other claim updates that take place so that they can continue to provide the best possible level of care to their patients.