billing the dmercs and others for infusion pumps - ION Solutions

PARTIAL MONTH BILLING (MEDICARE)??? Effective for dates of service on or after April 1, 2002, a newmodifier has been established to indicate billing of durablemedical equipment for a partial month of service: KR Rentalitem - billing for partial month.Suppliers who wish to exercise the option of billing Medicare for apartial month(s) of rental on DME should use the KR modifier afterthe pricing modifier.Although suppliers are entitled to bill and receive a full month’sreimbursement for rented DME provided to qualifying beneficiaries,suppliers now have the option of billing for a partial month of serviceand receiving reimbursement on a prorated basis by using the KRmodifier. A supplier has the option to bill a partial month for suppliesor for equipment if the supplier wants to avoid causing an overlapclaim.Suppliers who elect to bill for partial months should enter the date ofservice the rental period begins in the “From” field and the endingrental date of service in the “To” field of the HCFA-1500 (12-90) claimform for each partial month of billing. The modifier RR, indicatingrental, must also be appended to the claim line for the partial monthrental item(s). (Source: CIGNA Provider Bulletin 2002) Some payers (e.g. United) will pay ONLY a full month, evenwith this modifier.