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CGS Associates, LLC

August 25, 2017

Adding the KE Modifier: Instructions for Reopening a Claim Adjusted Under the Cures Act

CGS has received 100% of the claims expected under the 21st Century Cures Act. While there are some claims still in varying stages of the adjustment process, CGS can begin accepting Reopenings to add the KE modifier on applicable claims.

Based on the Cures Act, the KE modifier can be added to certain accessories used with a non-competitive bid base for dates of service July 1, 2016, through December 31, 2016. Claims that meet the criteria for addition of the KE modifier under the Cures Act must be submitted using the special Cures Adjustment KE Modifier Reopening Request formPDF.

Many of you may have multiple claims requiring addition of the KE modifier. CGS will accept those via spreadsheet. If using a spreadsheet, CGS asks that you use the KE Modifier templatePDF we have created OR you may create your own as long as it contains the following information:

NOTE: BEFORE preparing your spreadsheet, you must make certain that the claim(s) have completed processing. Refer to your Medicare Remittance Advice statements. Once you have confirmed the claim(s) have completed processing, you may add the required information to the spreadsheet.

Jurisdiction C suppliers may fax their KE Modifier Reopening Request formPDF and spreadsheet to 615.782.4649. If you wish to mail the information to Jurisdiction C, please send it to:

CGS Jurisdiction C
PO Box 20010
Nashville, TN 37202

Jurisdiction B suppliers may fax their KE Modifier Reopening Request formPDF and spreadsheet to 615-660-5978. If you wish to mail the information to Jurisdiction B, please send it to:

CGS Jurisdiction B
PO Box 20017
Nashville, TN 37202

CGS has published this information to our dedicated MM9968 webpage! Click on the banner on the jurisdiction homepage to see the most recent information as well as related links!

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