Nuclear Medicine Question for the Week of October 19, 2015

Question:

Question 

Would you clarify the use of modifier KX for the fourth PET scan for subsequent treatment strategy? Are hospitals required to use this modifier, or is it just for physicians?

Answer

Both hospitals and physicians (and non-hospital imaging centers) need to add modifier KX (requirements specified in the medical policy have been met) to the fourth or greater subsequent treatment strategy PET scan claim. For more on the modifier, see transmittal 3162 at http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3162CP.pdf  

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