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:
- Use of CR Modifier and "COVID-19" Narrative on Specified Claims Due to the COVID-19 PHE – Revised
- Correct Use of the KX Modifier During the COVID-19 PHE
- CMS Issues Interim Final Rules with Comment (CMS-1744-IFC & CMS-5531-IFC) – COVID-19 Public Health Emergency Joint DME MAC Article – Revised
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.