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News & Press: Government Affairs News

CMS Releases Specifics on Therapy Claims Reprocessing

Thursday, March 29, 2018   (0 Comments)
Posted by: Bradley Coffey, MA, AAOE Government Affairs
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Baltimore, MD - In its latest edition of MLN Matters, the Centers for Medicare and Medicaid Services (CMS) has announced specifics concerning therapy claims withheld or denied during the first month and a half of 2018.

  • The Medicare Audit Contractors (MACs) will reprocess therapy claims with the KX modifier containing Dates of Service in Calendar Year 2018, which were denied prior to the implementation of the updated legislative effective dates issued on January 25, 2018. NOTE: For institutional claims, these claims will include revenue codes 042x, 043x, or 044x and modifiers GN, GO, or GP.
  • The MACs will reprocess therapy claims with the KX modifier which were denied due to an invalid date provided by CMS on February 12, 2018.
  • The MACs will reprocess 2018 therapy claims which cannot be automatically reprocessed only if you bring such claims to the attention of your MAC.

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