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Modifier KL


KL DMEPOS Item Delivered via Mail

Contract suppliers must use the KL modifier on all claims for diabetic supply codes that are furnished via mail order. Non contract suppliers that furnish mail order diabetic supplies to beneficiaries who do not live in CBAs must also continue to use the KL modifier with these codes. Suppliers that furnish mail-order diabetic supplies that fail to use the HCPCS modifier KL on the claim may be subject to significant penalties.

Effective January 1, 2009, the KL modifier has been changed from an informational modifier to a pricing modifier in the HCPCS file.

KL modifier will need to be used for all diabetic supply codes except for claims for items that a beneficiary or caregiver picks up in person from a local pharmacy or supplier storefront.

Modifier KL is applicable only for the below listed HCPCS codes

A4256    Normal, low, and high calibrator solution/chips

A4258    Spring-powered device for lancet, each

A4259    Lancets, per box of 100

Please note: Inappropriate use of a competitive bidding modifier on a competitive bidding claim is in violation of the law and may lead to claims denial and/or other corrective actions. The use of a competitive bidding modifier does not supersede existing Medicare modifier use requirements for a particular code, but rather should be used in addition, as required.

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