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February 22, 2021

CR Modifier Usage on Claims Impacted by the COVID-19 PHE

CGS continues to see an increase in claims submitted with the CR modifier, but missing the KX modifier or the claim narrative. As a reminder, please use the following guides when submitting claims:

  • Append a CR modifier and include a narrative of "COVID-19" to all claims that are affected by the COVID-19 PHE. The narrative should be entered into the NTE 2400 (line note) or NTE 2300 (claim note) segments of the American National Standard Institute (ANSI X12) format, field 390-BM of the National Council for Prescription Drug Program (NCPDP) format, or Item 19 of paper claims.
  • If appropriate, append the KX modifier according the instructions in the article, "Correct Use of the KX Modifier During the COVID-19 PHE."

The DME MACs have issued several joint publications to address the correct usage of the CR and KX modifiers:

Remember, if your claim is NOT related to COVID-19, do not bill with a CR modifier and narrative. Browse the DME COVID-19 webpage for additional information.


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