Reminder to pharmacies for correctly billing Part B claims using KX modifier for immunosuppressive drugs

Jan 11, 2019
The Bottom Line

In response to a 2017 OIG report noting that some pharmacies billed Medicare incorrectly for Part B claims using the KX modifier for immunosuppressive drugs, CMS has published several resources to clarify manual instructions and help pharmacies document the medical necessity of organ transplant and eligibility for Medicare coverage. Resources include the following:

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