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August 29, 2019

KF Modifier Use - Correct Coding

Joint DME MAC Publication

Suppliers are reminded that devices classified by the Food & Drug Administration (FDA) as Class III devices must be billed using the KF modifier (ITEM DESIGNATED BY FDA AS CLASS III DEVICE). The following HCPCS codes and their associated Local Coverage Determinations (LCD) have devices where the KF modifier is applicable:

For items classified by the FDA as a Class III device that do not have a specific HCPCS code assigned, use HCPCS code E1399 (DURABLE MEDICAL EQUIPMENT, MISCELLANEOUS) with the KF modifier appended.

The following HCPCS code also has products which are classified by the FDA as Class III devices.  Although not associated with a specific LCD, the KF modifier is required for claim submission of this HCPCS code as well.

HCPCS Code

Descriptor

LCD

E0764

FUNCTIONAL NEUROMUSCULAR STIMULATION, TRANSCUTANEOUS STIMULATION OF SEQUENTIAL MUSCLE GROUPS OF AMBULATION WITH COMPUTER CONTROL, USED FOR WALKING BY SPINAL CORD INJURED, ENTIRE SYSTEM, AFTER COMPLETION OF TRAINING PROGRAM

None (see National Coverage Determination 160.12External PDF)

This information will be added to the applicable LCD-related Policy Articles in an upcoming revision.  Please see the applicable Policy Articles for specific information.

Publication History

August 29, 2019

Originally Published

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